Healthcare Provider Details

I. General information

NPI: 1568330769
Provider Name (Legal Business Name): RIVERSIDE CHIROPRACTIC CENTER MAK PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2025
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3657 VAN BUREN BLVD
RIVERSIDE CA
92503-4249
US

IV. Provider business mailing address

3657 VAN BUREN BLVD
RIVERSIDE CA
92503-4249
US

V. Phone/Fax

Practice location:
  • Phone: 562-895-1913
  • Fax:
Mailing address:
  • Phone: 562-895-1913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. CHUN KEUNG MAK
Title or Position: CEO
Credential: DC, QME, CCSP, EMT
Phone: 562-895-1913