Healthcare Provider Details

I. General information

NPI: 1285774976
Provider Name (Legal Business Name): TAMAI CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 VISTA WAY STE H
OCEANSIDE CA
92054-6174
US

IV. Provider business mailing address

2530 VISTA WAY STE H
OCEANSIDE CA
92054-6174
US

V. Phone/Fax

Practice location:
  • Phone: 760-435-9390
  • Fax: 760-435-9393
Mailing address:
  • Phone: 760-435-9390
  • Fax: 760-435-9393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number StateCA

VIII. Authorized Official

Name: NATALIE SOONTHORNSWAD
Title or Position: BILLING ADMINISTRATOR
Credential:
Phone: 760-435-9390