MEDICARE: ETHOSANA PERFORMANCE & WELLNESS CHIROPRACTIC GROUP

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	225700000X	Massage Therapist
2	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1912846627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ETHOSANA PERFORMANCE & WELLNESS CHIROPRACTIC GROUP

Provider Business Mailing Address
First Line	:	275 SARATOGA AVE STE 260
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-6670
Country	:	US
Telephone Number	:	408-241-1777
Fax Number	:	408-241-1771

Provider Business Practice Location Address
First Line	:	275 SARATOGA AVE STE 260
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95050-6670
Country	:	US
Telephone Number	:	408-241-1777
Fax Number	:	408-241-1771

Authorized Official
Title or Position	:	OWNER
Name	:	SEPTIMIU COROIANU
Credential	:	DC
Telephone Number	:	408-241-1777

Provider Enumeration Date	:	03/27/2026
Last Update Date	:	03/27/2026

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