Healthcare Provider Details

I. General information

NPI: 1669771333
Provider Name (Legal Business Name): BARSOM AND BERLIN CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 BEAR ST SUITE 200
COSTA MESA CA
92626-2964
US

IV. Provider business mailing address

3140 BEAR ST SUITE 200
COSTA MESA CA
92626-2964
US

V. Phone/Fax

Practice location:
  • Phone: 714-751-2229
  • Fax:
Mailing address:
  • Phone: 714-751-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: ELLIOT BERLIN
Title or Position: SECRETARY/TREASURER
Credential: D.C.
Phone: 323-549-0070