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IDEAL SPINE & REHAB NPI 1205128949


NPI Information

NPI: 1205128949
Provider Name: IDEAL SPINE & REHAB
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
17251 17TH ST STE A&B
TUSTIN, CA
ZIP 92780
Phone: (714) 832-2273
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IDEAL SPINE & REHAB is a chiropractor in Tustin, CA. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. IDEAL SPINE & REHAB NPI is 1205128949. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

17251 17TH ST STE A&B
TUSTIN, CA
ZIP 92780-970
Phone: (714) 832-2273
Fax: (714) 832-2272

The provider's authorized official is Joseph Pacelli .
The authorized official title is Owner and has the following contact phone number (714) 832-2273.

The enumeration date for this NPI number is 5/13/2011 and was last updated on 11/30/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorDC30257CALIFORNIANo
2111N00000XChiropractorDC11750CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DC11750MEDICARE UPINCALIFORNIA
2DC30257MEDICARE UPINCALIFORNIA
3CB265178MEDICARE UPINCALIFORNIA
4HI564ZMEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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