Provider Demographics
NPI:1245345644
Name:CHAPARRO, JORGE (DC)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:
Last Name:CHAPARRO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-3722
Mailing Address - Country:US
Mailing Address - Phone:213-627-0287
Mailing Address - Fax:213-627-8428
Practice Address - Street 1:112 W 9TH ST
Practice Address - Street 2:1126
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-1510
Practice Address - Country:US
Practice Address - Phone:213-627-0287
Practice Address - Fax:213-627-8428
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor