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General NPI Number Information
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NPI Number | 1568271252
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Entity Type | Organization
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Legal Business Name | GARY R. MARTIN, D.C., CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 4330 BARRANCA PKWY STE 150B
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City | IRVINE
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State | CA
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Zip | 92604-1704
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Country | US
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Telephone | 949-559-7999
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Fax | 949-559-8097
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Provider Business Mailing Address
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Address Line | 4330 BARRANCA PKWY STE 150B
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City | IRVINE
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State | CA
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Zip | 92604-1704
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Country | US
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Telephone | 949-559-7999
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Fax | 949-559-8097
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY R. MARTIN
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Credential | D.C.
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Telephone | 949-559-7999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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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 |
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License Number State |
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