Provider Demographics
NPI:1427106913
Name:TOSCZAK CHIROPRACTIC INC A PROFESSIONAL CORP
Entity type:Organization
Organization Name:TOSCZAK CHIROPRACTIC INC A PROFESSIONAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TOSCZAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-758-4325
Mailing Address - Street 1:1938 VIA CTR STE B
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-6056
Mailing Address - Country:US
Mailing Address - Phone:760-758-4325
Mailing Address - Fax:760-639-4325
Practice Address - Street 1:1938 VIA CTR STE B
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6056
Practice Address - Country:US
Practice Address - Phone:760-758-4325
Practice Address - Fax:760-639-4325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29235111N00000X
CADC29284111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19189OtherGROUP PTAN