Healthcare Provider Details

I. General information

NPI: 1770416083
Provider Name (Legal Business Name): HERNANDEZ GARCIA PROFESSIONAL CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 STANDIFORD AVE STE B
MODESTO CA
95350-0730
US

IV. Provider business mailing address

1421 STANDIFORD AVE STE B
MODESTO CA
95350-0730
US

V. Phone/Fax

Practice location:
  • Phone: 209-521-1122
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JORDI HERNANDEZ-GARCIA
Title or Position: OWNER
Credential: DC
Phone: 209-521-1122