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General NPI Number Information
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NPI Number | 1902413107
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Entity Type | Organization
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Legal Business Name | MINA ROSHANKAR CHIROPRACTIC INC
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Dates
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Enumeration Date | 09/30/2020
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 1076 E 1ST ST STE A
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City | TUSTIN
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State | CA
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Zip | 92780-3852
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Country | US
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Telephone | 949-756-1003
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Fax | 888-290-1158
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Provider Business Mailing Address
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Address Line | 1076 E 1ST ST STE A
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City | TUSTIN
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State | CA
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Zip | 92780-3852
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Country | US
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Telephone | 949-756-1003
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Fax | 888-290-1158
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Authorized Official
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Title or Position | CHIROPRACTOR/ OWNER
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Name | DR. MINA ROSHANKAR
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Credential | DC
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Telephone | 949-756-1003
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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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