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General NPI Number Information
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NPI Number | 1194253286
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Entity Type | Organization
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Legal Business Name | ORTEGA CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 06/01/2017
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Last Update Date | 06/01/2017
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Provider Practice Location Address
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Address Line | 5005 TEXAS ST STE 301
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City | SAN DIEGO
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State | CA
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Zip | 92108-3724
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Country | US
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Telephone | 619-296-5655
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Fax | 619-296-7647
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Provider Business Mailing Address
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Address Line | 5005 TEXAS ST STE 301
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City | SAN DIEGO
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State | CA
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Zip | 92108-3724
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Country | US
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Telephone | 619-296-5655
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Fax | 619-296-7647
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH ORTEGA
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Credential | DC
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Telephone | 619-296-5655
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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 | DC24190
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License Number State | CA
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