Healthcare Provider Details

I. General information

NPI: 1912845892
Provider Name (Legal Business Name): ORTIZ-RIVERA SPINE CARE DOCTORS CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 S WATERMAN AVE STE C
SAN BERNARDINO CA
92408-2852
US

IV. Provider business mailing address

1850 S WATERMAN AVE STE C
SAN BERNARDINO CA
92408-2852
US

V. Phone/Fax

Practice location:
  • Phone: 424-214-8068
  • Fax:
Mailing address:
  • Phone: 909-900-4633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: XAVIER ANTONIO ORTIZ RAMIREZ
Title or Position: MANAGING MEMBER,CO-OWNER
Credential:
Phone: 424-214-8068