Healthcare Provider Details

I. General information

NPI: 1962624429
Provider Name (Legal Business Name): CHLUPEK CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13172 SAINT THOMAS DR
NORTH TUSTIN CA
92705
US

IV. Provider business mailing address

PO BOX 1026
TUSTIN CA
92781
US

V. Phone/Fax

Practice location:
  • Phone: 714-734-5600
  • Fax: 714-734-5622
Mailing address:
  • Phone: 714-734-5600
  • Fax: 714-734-5622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number17650
License Number StateCA

VIII. Authorized Official

Name: DR. BARBARA ANNE CHLUPEK
Title or Position: OWNER MANAGER
Credential: DC
Phone: 714-734-5600