MARIELLA CHIROPRACTIC INC , NPI 1124198007 — BODY STRUCTURE in LOS ANGELES (CA)

NPI 1124198007

13+ Years Experience Organization

MARIELLA CHIROPRACTIC INC

Other organization name: BODY STRUCTURE. Name type code: 3 - doing business as (d/b/ a) name.

11.08.2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1124198007
NPI NUMBER

About MARIELLA CHIROPRACTIC INC

MARIELLA CHIROPRACTIC INC is a provider established in LOS ANGELES, CA. The NPI number of MARIELLA CHIROPRACTIC INC is 1124198007 and was assigned on 11.08.2006. The practitioners primary taxonomy code is: 111N00000X CA .

Mailing address

  • City: LOS ANGELES
  • State: CA
  • Postal code: 90038
  • Phone: 3234698062
  • Fax: 3234698064
  • Address: 1011 NORTH COLE AVENUE

Primary Practice Address

  • Region : LOS ANGELES, CA
  • NPI : 1124198007
  • Phone : 3234698062
  • Fax : 3234698064
  • Postalcode : 90038
  • Address : 1011 NORTH COLE AVENUE

Provider taxonomy - Chiropractor

  • Taxonomy code: 111N00000X
  • License state: CA

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy group: 193400000X SINGLE SPECIALTY GROUP.

Taxonomy description: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Contacts:

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  • MARIELLA CHIROPRACTIC INC
  • Address : 1011 NORTH COLE AVENUE
  • Region : LOS ANGELES, CA
  • NPI : 1124198007
  • Phone : 3234698062
  • Fax : 3234698064
  • Postalcode : 90038

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 3234698062
  • Title or position : PRESIDENT
  • Credentials : DC

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address1011 NORTH COLE AVENUE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLOS ANGELES
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCA
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code90038
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3234698062
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3234698064
The fax number associated with the location address of the provider being identified.
NPI1124198007
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1111N00000X
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Provider Enumeration Date11.08.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MARIELLA CHIROPRACTIC INC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameBODY STRUCTURE
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address1011 NORTH COLE AVENUE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameLOS ANGELES
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameCA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code90038
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3234698062
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number3234698064
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameMARIELLA
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameGEORGE
The first name of the authorized official
Authorized Official Middle NameMICHAEL
The middle name of the authorized official
Authorized Official Title or PositionPRESIDENT
The title or position of the authorized official
Authorized Official Name Prefix TextMR.
Authorized Official Name Prefix Text
Authorized Official Credential TextDC
Authorized Official Credential Text
Authorized Official Telephone Number3234698062
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1111N00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Provider License Number State Code 1CA
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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