Healthcare Provider Details

I. General information

NPI: 1801141338
Provider Name (Legal Business Name): SATNICK CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2012
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12880 RANCHO PENASQUITOS BLVD STE C
SAN DIEGO CA
92129-2966
US

IV. Provider business mailing address

12880 RANCHO PENASQUITOS BLVD STE C
SAN DIEGO CA
92129-2966
US

V. Phone/Fax

Practice location:
  • Phone: 858-484-2000
  • Fax: 858-484-3414
Mailing address:
  • Phone: 858-484-2000
  • Fax: 858-484-3414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC11437
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberB1985010318
License Number StateCA

VIII. Authorized Official

Name: DR. CLAUDETTE ROSE NASSOOR-SATNICK
Title or Position: CLINIC DIRECTOR
Credential: D.C.
Phone: 858-484-2000