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General NPI Number Information
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NPI Number | 1518254267
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Entity Type | Organization
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Legal Business Name | CHIROPRACTICE HEALTH CARE OF RANCHO SANTA MARGARITA
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Dates
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Enumeration Date | 07/01/2011
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Last Update Date | 07/01/2011
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Provider Practice Location Address
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Address Line | 29851 AVENTURA STE M
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-2014
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Country | US
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Telephone | 949-459-9163
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Fax | 949-459-2318
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Provider Business Mailing Address
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Address Line | PO BOX 80005
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City | RANCHO SANTA MARGARITA
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State | CA
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Zip | 92688-0005
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Country | US
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Telephone | 949-459-9163
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Fax | 949-459-2318
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID A JOHNSON
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Credential | DC
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Telephone | 949-459-9163
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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 | DC21725
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License Number State | CA
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