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General NPI Number Information
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NPI Number | 1770764474
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Entity Type | Organization
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Legal Business Name | BUDINCICH CHIROPRACTIC CLINIC, INC
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 140 N HILL AVE
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City | PASADENA
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State | CA
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Zip | 91106-1907
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Country | US
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Telephone | 626-792-3390
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Fax | 626-792-8302
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Provider Business Mailing Address
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Address Line | 140 N HILL AVE
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City | PASADENA
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State | CA
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Zip | 91106-1907
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Country | US
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Telephone | 626-792-3390
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Fax | 626-792-8302
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Authorized Official
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Title or Position | DIRECTOR
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Name | MICHAEL BUDINCICH
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Credential | D.C., QME
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Telephone | 626-792-3390
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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 | DC13956
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License Number State | CA
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