100 Chiropractic Panchal Livingood Apc
Organization Active NPI Chiropractor · La Habra, CA
NPI 1255034864 · NPPES record last updated Mar 23, 2023
Key facts
- NPI
- 1255034864
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- 100 CHIROPRACTIC PANCHAL LIVINGOOD APC
- Practice address
- 1921 W Imperial Hwy Ste B
La Habra, CA 90631-0613 - Phone
- (719) 217-0895
- NPI assigned
- Mar 23, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Brandon Livingood
- Title
- Owner
- Phone
- (719) 244-5142
Practitioners 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240202001472 | CA | Part B Supplier - Clinic/Group Practice | 3971956244 |
Receives reassigned benefits from 2 practitioners Practice locations: La Habra, CA |
National Provider Directory
Locations
1921 W Imperial Hwy
Ste B
La Habra, CA 90631
Phone (562) 383-7158
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
1921 W Imperial Hwy Ste B
La Habra, CA 90631-0613
Mailing address
1921 W Imperial Hwy Ste B
La Habra, CA 90631-0613
Other providers in La Habra, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.