Provider Demographics
NPI:1528460979
Name:CHRISTINA CHIROPRACTIC, INC
Entity type:Organization
Organization Name:CHRISTINA CHIROPRACTIC, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHONG
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-736-5456
Mailing Address - Street 1:4600 BEACH BLVD., #G
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621
Mailing Address - Country:US
Mailing Address - Phone:714-736-5456
Mailing Address - Fax:714-736-5461
Practice Address - Street 1:4600 BEACH BLVD., #G
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621
Practice Address - Country:US
Practice Address - Phone:714-736-5456
Practice Address - Fax:714-736-5461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty