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Organization
M E HALOUZKA DC PC
Active
Organization
M E HALOUZKA DC PC
Active
Other names
M E HALOUZKA DC PC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY ELIZABETH HALOUZKA DC (CHIROPRACTOR)
(858) 391-0434
Entity
Organization
Contact information
Practice address
12348 CREEKVIEW DRIVE, SAN DIEGO, CA 92128
(858) 391-0434
Mailing address
12348 CREEKVIEW DRIVE, SAN DIEGO, CA 92128
(858) 391-0434
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
20615
CA
111NS0005X
Sports Physician Chiropractor
20615DC
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W17196
MEDICARE GROUP NUMBER
CA
Enumeration date
10/17/2007
Last updated
02/21/2008
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