Healthcare Provider Details

I. General information

NPI: 1588427934
Provider Name (Legal Business Name): JULIE STEFANSKI, D.C., CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 NEWPORT BLVD
NEWPORT BEACH CA
92663-3724
US

IV. Provider business mailing address

2830 NEWPORT BLVD
NEWPORT BEACH CA
92663-3724
US

V. Phone/Fax

Practice location:
  • Phone: 719-650-4461
  • Fax: 949-608-3611
Mailing address:
  • Phone: 719-650-4461
  • Fax: 949-608-3611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULIE STEFANSKI
Title or Position: OWNER/CHIROPRACTOR
Credential:
Phone: 719-650-4461