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General NPI Number Information
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NPI Number | 1235477837
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Entity Type | Organization
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Legal Business Name | SYN-CARE WELLNESS CENTER, INC.
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 3445 PACIFIC COAST HIGHWAY 300A
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City | TORRANCE
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State | CA
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Zip | 90505-6660
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Country | US
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Telephone | 310-325-3044
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Fax | 310-325-3041
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Provider Business Mailing Address
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Address Line | 3445 PACIFIC COAST HWY 300A
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City | TORRANCE
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State | CA
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Zip | 90505-6660
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Country | US
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Telephone | 310-325-3044
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Fax | 310-325-3041
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOMENIC DIDOMENICANTONIO
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Credential | D.C.
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Telephone | 310-325-3044
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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 | DC19629
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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 | DC27596
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License Number State | CA
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