Provider Demographics
NPI:1801081179
Name:PHIN, DOLORES ANNE (DC)
Entity type:Individual
Prefix:DR
First Name:DOLORES
Middle Name:ANNE
Last Name:PHIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-1826
Mailing Address - Country:US
Mailing Address - Phone:619-437-4900
Mailing Address - Fax:619-437-4909
Practice Address - Street 1:543 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:CORONADO
Practice Address - State:CA
Practice Address - Zip Code:92118-1826
Practice Address - Country:US
Practice Address - Phone:619-437-4900
Practice Address - Fax:619-437-4909
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 22027111NP0017X
FLCH 9297111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor