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General NPI Number Information
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NPI Number | 1124632757
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Entity Type | Organization
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Legal Business Name | NECK & BACK PAIN SPECIALISTS, A BALTA CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 10231 SLATER AVE. #113
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708
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Country | US
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Telephone | 714-968-4446
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Fax | 714-965-4968
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Provider Business Mailing Address
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Address Line | 10231 SLATER AVE. #113
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708
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Country | US
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Telephone | 714-968-4446
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Fax | 714-965-4968
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Authorized Official
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Title or Position | PRESIDENT
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Name | ABDEL BALTA
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Credential | D.C.
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Telephone | 714-968-4446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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