Provider Demographics
NPI:1043335128
Name:DELJUNCO, JAVIER FRANK (DC)
Entity type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:FRANK
Last Name:DELJUNCO
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 1:9723 ALONDRA BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-3603
Mailing Address - Country:US
Mailing Address - Phone:562-804-5175
Mailing Address - Fax:562-804-5180
Practice Address - Street 1:9723 ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-3603
Practice Address - Country:US
Practice Address - Phone:562-804-5175
Practice Address - Fax:562-804-5180
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC14901Medicare ID - Type Unspecified