Healthcare Provider Details

I. General information

NPI: 1952448664
Provider Name (Legal Business Name): MICHAEL ROBERT CZAPLA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 IRVINE AVE SUITE 116
COSTA MESA CA
92627-4653
US

IV. Provider business mailing address

2675 IRVINE AVE SUITE 116
COSTA MESA CA
92627-4653
US

V. Phone/Fax

Practice location:
  • Phone: 949-631-0200
  • Fax: 949-631-2050
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC 29276
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: