Basic Information
| Provider Information | |||||||||
| NPI: | 1649500547 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MARY TRUMPI CHIROPRACTIC, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 WILSHIRE BLVD STE 410 | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904011886 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 900 WILSHIRE BLVD STE 410 | ||||||||
| Address2: | |||||||||
| City: | SANTA MONICA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 904011886 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104581259 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2009 | ||||||||
| LastUpdateDate: | 12/28/2009 | ||||||||
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| AuthorizedOfficialLastName: | TRUMPI | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3104581259 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111NS0005X | 27959 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Chiropractic Providers | Chiropractor | Sports Physician |
No ID Information.