MEDICARE: GOOING CHIROPRACTIC CLINIC 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	111N00000X	Chiropractor	DC14925	CA

General Provider Information

NPI Number	:	1962742270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOING CHIROPRACTIC CLINIC INC

Provider Business Mailing Address
First Line	:	2787 BRISTOL ST
Second Line	:	SUITE 102
City	:	COSTA MESA
State	:	CA
Zip	:	92626-5956
Country	:	US
Telephone Number	:	714-556-9188
Fax Number	:

Provider Business Practice Location Address
First Line	:	2787 BRISTOL ST
Second Line	:	SUITE 102
City	:	COSTA MESA
State	:	CA
Zip	:	92626-5956
Country	:	US
Telephone Number	:	714-556-9188
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL GOOING
Credential	:	D.C.
Telephone Number	:	714-556-9188

Provider Enumeration Date	:	02/22/2013
Last Update Date	:	03/08/2013

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