Healthcare Provider Details

I. General information

NPI: 1053220327
Provider Name (Legal Business Name): CARR CHIROPRACTIC PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 GENESEE AVE STE 201
SAN DIEGO CA
92117-4940
US

IV. Provider business mailing address

4340 GENESEE AVE STE 201
SAN DIEGO CA
92117-4940
US

V. Phone/Fax

Practice location:
  • Phone: 619-637-9086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MARCUS CARR
Title or Position: OWNER/PRESIDENT
Credential: DC
Phone: 619-637-9086