Provider Demographics
NPI:1588876239
Name:MICHAEL A. RINTALA, PROFESSIONAL CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:MICHAEL A. RINTALA, PROFESSIONAL CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:RINTALA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-481-0303
Mailing Address - Street 1:12264 EL CAMINO REAL
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3058
Mailing Address - Country:US
Mailing Address - Phone:858-481-0303
Mailing Address - Fax:858-481-9797
Practice Address - Street 1:12264 EL CAMINO REAL
Practice Address - Street 2:SUITE 108
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-3058
Practice Address - Country:US
Practice Address - Phone:858-481-0303
Practice Address - Fax:858-481-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25611111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA74026Medicare UPIN