Provider Demographics
NPI:1548330442
Name:BABCOCK, ARMANDO ROMAN (DC)
Entity type:Individual
Prefix:DR
First Name:ARMANDO
Middle Name:ROMAN
Last Name:BABCOCK
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 1:2780 E RIVERSIDE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-7489
Mailing Address - Country:US
Mailing Address - Phone:909-923-6777
Mailing Address - Fax:909-923-0774
Practice Address - Street 1:2780 E RIVERSIDE DR
Practice Address - Street 2:SUITE A
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-7489
Practice Address - Country:US
Practice Address - Phone:909-923-6777
Practice Address - Fax:909-923-0774
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC22961OtherCA LICENSE NUMBER