Healthcare Provider Details

I. General information

NPI: 1639861388
Provider Name (Legal Business Name): OMAR GARCIA D C A CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32246 CLINTON KEITH RD STE 102
WILDOMAR CA
92595-7320
US

IV. Provider business mailing address

32246 CLINTON KEITH RD STE 102
WILDOMAR CA
92595-7320
US

V. Phone/Fax

Practice location:
  • Phone: 951-678-9063
  • Fax: 951-678-2893
Mailing address:
  • Phone: 951-678-9063
  • Fax: 951-678-2893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: OMAR GARCIA
Title or Position: CHIROPRACTOR
Credential:
Phone: 951-216-8768