Provider Demographics
NPI:1710788757
Name:LEIGSRING QUIROA, CRISTIAN (DC)
Entity type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:
Last Name:LEIGSRING QUIROA
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 1:1247 PETIT AVE APT 458
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-2677
Mailing Address - Country:US
Mailing Address - Phone:805-796-4494
Mailing Address - Fax:
Practice Address - Street 1:6200 CANOGA AVE STE 105
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-7793
Practice Address - Country:US
Practice Address - Phone:818-222-1120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC37218111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician