Provider Demographics
NPI:1447328802
Name:PIRRITANO, JOHN ANTHONY (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTHONY
Last Name:PIRRITANO
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 1:601 N AVALON BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-5870
Mailing Address - Country:US
Mailing Address - Phone:310-513-9100
Mailing Address - Fax:310-513-9247
Practice Address - Street 1:601 N AVALON BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-5870
Practice Address - Country:US
Practice Address - Phone:310-513-9100
Practice Address - Fax:310-513-9100
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26122111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor