# SURACES CHIROPRACTIC BACK ALERT CLINIC, A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144550450
- **Authorized official:** DR. VINCENT J. SURACE D.C. (CHIROPRACTOR)
- **Authorized official phone:** (310) 831-5700

## Contact information

- **Practice address:** 643 S BUTTE ST, SAN PEDRO, CA 90732-3510
- **Practice address phone:** (310) 831-5700
- **Practice address fax:** (310) 831-5700
- **Mailing address:** 643 S BUTTE ST, SAN PEDRO, CA 90732-3510
- **Mailing address phone:** (310) 831-5700
- **Mailing address fax:** (310) 831-5700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 10283 | CA | Yes |

## Other

- **Enumeration date:** 01/08/2010
- **Last updated:** 08/04/2016