Healthcare Provider Details

I. General information

NPI: 1811534415
Provider Name (Legal Business Name): JEPSEN CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2019
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7330 ENGINEER RD STE C
SAN DIEGO CA
92111-1434
US

IV. Provider business mailing address

7330 ENGINEER RD STE C
SAN DIEGO CA
92111-1434
US

V. Phone/Fax

Practice location:
  • Phone: 858-987-1002
  • Fax:
Mailing address:
  • Phone: 515-865-6946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER JEPSEN
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 515-865-6946