Healthcare Provider Details

I. General information

NPI: 1154597003
Provider Name (Legal Business Name): ZEN CARE CHIROPRACTIC WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 WATERWORKS WAY #115
IRVINE CA
92618-3171
US

IV. Provider business mailing address

113 WATERWORKS WAY #115
IRVINE CA
92618-3171
US

V. Phone/Fax

Practice location:
  • Phone: 949-727-1772
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC27769
License Number StateCA

VIII. Authorized Official

Name: CHRISTINE HA
Title or Position: CHIROPRACTOR
Credential:
Phone: 949-727-1772