Healthcare Provider Details

I. General information

NPI: 1629693635
Provider Name (Legal Business Name): KIRCHNER CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27401 LOS ALTOS STE 300
MISSION VIEJO CA
92691-7608
US

IV. Provider business mailing address

27902 MUIRFIELD
MISSION VIEJO CA
92692-1576
US

V. Phone/Fax

Practice location:
  • Phone: 949-831-1932
  • Fax:
Mailing address:
  • Phone: 949-751-8328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT KIRCHNER
Title or Position: OWNER
Credential: DC
Phone: 949-751-8328