Healthcare Provider Details

I. General information

NPI: 1518154939
Provider Name (Legal Business Name): JASON A. COPPING CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2007
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 MANCHESTER AVE 202
ENCINITAS CA
92024-4938
US

IV. Provider business mailing address

4401 MANCHESTER AVE 202
ENCINITAS CA
92024
US

V. Phone/Fax

Practice location:
  • Phone: 760-436-4006
  • Fax: 760-436-4007
Mailing address:
  • Phone: 760-436-7999
  • Fax: 760-436-3993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC27498
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC27409
License Number StateCA

VIII. Authorized Official

Name: DR. JASON COPPING
Title or Position: PRESIDENT
Credential: D.C.
Phone: 760-436-7999