Healthcare Provider Details

I. General information

NPI: 1629772140
Provider Name (Legal Business Name): THE SPINE INSTITUTE HABCHI CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12865 POINTE DEL MAR WAY STE 170
DEL MAR CA
92014-3861
US

IV. Provider business mailing address

12865 POINTE DEL MAR WAY STE 170
DEL MAR CA
92014-3861
US

V. Phone/Fax

Practice location:
  • Phone: 858-720-8380
  • Fax:
Mailing address:
  • Phone: 858-720-8380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER HABCHI
Title or Position: PRESIDENT
Credential: D.C.
Phone: 858-504-1673