Healthcare Provider Details

I. General information

NPI: 1568271252
Provider Name (Legal Business Name): GARY R. MARTIN, D.C., CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4902 IRVINE CENTER DR STE 201
IRVINE CA
92604-3335
US

IV. Provider business mailing address

4902 IRVINE CENTER DR STE 201
IRVINE CA
92604-3335
US

V. Phone/Fax

Practice location:
  • Phone: 949-590-9228
  • Fax:
Mailing address:
  • Phone: 949-590-9228
  • 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

VIII. Authorized Official

Name: GARY R. MARTIN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 949-559-7999