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General NPI Number Information
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NPI Number | 1720421316
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Entity Type | Organization
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Legal Business Name | TUSTIN ELITE CHIROPRACTIC
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Dates
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Enumeration Date | 04/12/2013
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Last Update Date | 04/23/2013
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Provider Practice Location Address
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Address Line | 17291 IRVINE BLVD SUITE 103
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City | TUSTIN
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State | CA
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Zip | 92780-2941
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Country | US
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Telephone | 714-202-2460
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Fax | 714-202-2795
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Provider Business Mailing Address
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Address Line | 17291 IRVINE BLVD SUITE 103
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City | TUSTIN
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State | CA
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Zip | 92780-2941
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Country | US
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Telephone | 714-202-2460
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Fax | 714-202-2795
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Authorized Official
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Title or Position | OWNER
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Name | DR. SALMAN KHANAKI
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Credential | D.C.
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Telephone | 714-202-2460
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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 | DC32196
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC15326
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC32280
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License Number State | CA
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