Provider Demographics
NPI:1881003390
Name:SECOND TO NONE MANAGEMENT LLC
Entity type:Organization
Organization Name:SECOND TO NONE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:TALERICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-399-1227
Mailing Address - Street 1:171 PIER AVE # 261
Mailing Address - Street 2:SUITE #261
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-5311
Mailing Address - Country:US
Mailing Address - Phone:310-399-1227
Mailing Address - Fax:310-396-0220
Practice Address - Street 1:3002 MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-5318
Practice Address - Country:US
Practice Address - Phone:310-314-0220
Practice Address - Fax:310-396-0220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty