MEDICARE: RONCO CHIROPRACTIC INCORPORATED

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
1	111N00000X	Chiropractor	DC27851	CA

General Provider Information

NPI Number	:	1366757809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONCO CHIROPRACTIC INCORPORATED

Provider Business Mailing Address
First Line	:	11230 SORRENTO VALLEY RD STE 140
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1338
Country	:	US
Telephone Number	:	858-481-1422
Fax Number	:	858-481-1388

Provider Business Practice Location Address
First Line	:	11230 SORRENTO VALLEY RD STE 140
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1338
Country	:	US
Telephone Number	:	858-481-1422
Fax Number	:	858-481-1388

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	LISA RONCO
Credential	:
Telephone Number	:	858-481-1422

Provider Enumeration Date	:	08/09/2010
Last Update Date	:	01/26/2026

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