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General NPI Number Information
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NPI Number | 1669701678
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Entity Type | Organization
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Legal Business Name | POLLACK CHIROPRACTIC GROUP, INC
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Dates
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Enumeration Date | 12/22/2009
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Last Update Date | 12/22/2009
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Provider Practice Location Address
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Address Line | 4121 WESTERLY PL SUITE 116
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2322
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Country | US
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Telephone | 949-721-0606
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Fax | 949-945-1425
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Provider Business Mailing Address
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Address Line | 4121 WESTERLY PL SUITE 116
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-2322
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Country | US
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Telephone | 949-721-0606
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Fax | 949-945-1425
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK POLLACK
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Credential | D.C.
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Telephone | 949-721-0606
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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 |
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License Number State |
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