Provider Demographics
NPI:1538860176
Name:PITPITAN, ERIC JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JAMES
Last Name:PITPITAN
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 1:16523 POPPYGLEN LN
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-2091
Mailing Address - Country:US
Mailing Address - Phone:661-607-2765
Mailing Address - Fax:
Practice Address - Street 1:10345 LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-2743
Practice Address - Country:US
Practice Address - Phone:562-287-8884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor