Healthcare Provider Details

I. General information

NPI: 1346624848
Provider Name (Legal Business Name): BESTCARE CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2015
Last Update Date: 07/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10349 BALBOA BLVD STE 200
GRANADA HILLS CA
91344-7379
US

IV. Provider business mailing address

10349 BALBOA BLVD STE 200
GRANADA HILLS CA
91344-7379
US

V. Phone/Fax

Practice location:
  • Phone: 818-363-3100
  • Fax: 818-363-5353
Mailing address:
  • Phone: 818-363-3100
  • Fax: 818-363-5353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number30563
License Number StateCA

VIII. Authorized Official

Name: EDWARD JUNG
Title or Position: PRESIDENT
Credential: DC
Phone: 818-363-3100