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NPI Code Detail

MEDICARE: PACIFIC EMPIRE CHIROPRACTIC A PROFESSIONAL CHIROPRACTIC CORPORATION

MEDICARE: PACIFIC EMPIRE CHIROPRACTIC A PROFESSIONAL CHIROPRACTIC CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC21111CA

General Provider Information

NPI Number : 1043426166
Entity Type Code : Organization
Provider Name (Legal Business Name) : PACIFIC EMPIRE CHIROPRACTIC A PROFESSIONAL CHIROPRACTIC CORPORATION
Provider Business Mailing Address
First Line : 4590 RIVERSIDE DR
Second Line : SUITE B
City : CHINO
State : CA
Zip : 91710-3980
Country : US
Telephone Number : 909-464-9880
Fax Number : 909-591-4720
Provider Business Practice Location Address
First Line : 4590 RIVERSIDE DR
Second Line : SUITE B
City : CHINO
State : CA
Zip : 91710-3980
Country : US
Telephone Number : 909-464-9880
Fax Number : 909-591-4720
Authorized Official
Title or Position : OWNER
Name : DR. GARY L SANNES
Credential : DC
Telephone Number : 909-464-9880
Provider Enumeration Date : 05/15/2007
Last Update Date : 07/28/2009

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Directions to “PACIFIC EMPIRE CHIROPRACTIC A PROFESSIONAL CHIROPRACTIC CORPORATION ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.