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General NPI Number Information
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NPI Number | 1134127103
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Entity Type | Organization
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Legal Business Name | WAYNE M WHALEN D C A CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 9570 CUYAMACA ST STE 101
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City | SANTEE
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State | CA
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Zip | 92071-2690
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Country | US
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Telephone | 619-258-1144
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Fax | 619-258-6887
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Provider Business Mailing Address
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Address Line | 9570 CUYAMACA ST STE 101
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City | SANTEE
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State | CA
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Zip | 92071-2690
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Country | US
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Telephone | 619-258-1144
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Fax | 619-258-6887
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Authorized Official
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Title or Position | PRESIDENT
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Name | WAYNE MARTIN WHALEN
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Credential | DC
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Telephone | 619-258-1144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 18999
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC18999
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License Number State | CA
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