Provider Demographics
NPI:1043736564
Name:MATIN CHIROPRACTIC GROUP, INC.
Entity Type:Organization
Organization Name:MATIN CHIROPRACTIC GROUP, INC.
Other - Org Name:MATIN FAMILY CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUJAN
Authorized Official - Middle Name:JUBIN
Authorized Official - Last Name:MATIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:803-609-3216
Mailing Address - Street 1:4330 BARRANCA PKWY STE 245
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-1704
Mailing Address - Country:US
Mailing Address - Phone:803-609-3216
Mailing Address - Fax:949-786-7114
Practice Address - Street 1:4330 BARRANCA PKWY STE 245
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-1704
Practice Address - Country:US
Practice Address - Phone:803-609-3216
Practice Address - Fax:949-786-7114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33499111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty