Provider Demographics
NPI:1053538025
Name:ARROYO, SUSANA EDELINA (DC)
Entity type:Individual
Prefix:DR
First Name:SUSANA
Middle Name:EDELINA
Last Name:ARROYO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13116 NEFF RD
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-6220
Mailing Address - Country:US
Mailing Address - Phone:562-201-4222
Mailing Address - Fax:626-442-2640
Practice Address - Street 1:11227 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-3225
Practice Address - Country:US
Practice Address - Phone:626-442-2707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor