MEDICARE: JOO CHIROPRACTIC INC

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1437785540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOO CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	4655 RUFFNER ST STE 120
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-2226
Country	:	US
Telephone Number	:	858-292-0256
Fax Number	:	858-292-0459

Provider Business Practice Location Address
First Line	:	4655 RUFFNER ST STE 120
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-2226
Country	:	US
Telephone Number	:	858-292-0256
Fax Number	:	858-292-0459

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DAVID JOO
Credential	:	DC
Telephone Number	:	858-292-0256

Provider Enumeration Date	:	03/20/2020
Last Update Date	:	03/11/2021

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Directions to “JOO CHIROPRACTIC INC ” Practice Location

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