Basic Information
Provider Information
NPI: 1003140120
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PINEDA
FirstName: KARLA
MiddleName: ALBINA
NamePrefix: DR.
NameSuffix:  
Credential: D.C.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6221 WILSHIRE BLVD
Address2: SUITE 518
City: LOS ANGELES
State: CA
PostalCode: 900485201
CountryCode: US
TelephoneNumber: 3235490070
FaxNumber: 3235490040
Practice Location
Address1: 6221 WILSHIRE BLVD
Address2: SUITE 518
City: LOS ANGELES
State: CA
PostalCode: 900485201
CountryCode: US
TelephoneNumber: 3235490070
FaxNumber: 3235490040
Other Information
ProviderEnumerationDate: 09/22/2009
LastUpdateDate: 09/22/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
111N00000XDC-31403CAY Chiropractic ProvidersChiropractor 

No ID Information.


Home