Provider Demographics
NPI:1053492942
Name:CELESTIAL MANAGEMENT INC
Entity Type:Organization
Organization Name:CELESTIAL MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALOYRA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:925-934-5088
Mailing Address - Street 1:95 ARGONAUT
Mailing Address - Street 2:280
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-4133
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:1610 OAK PARK BLVD
Practice Address - Street 2:2
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4489
Practice Address - Country:US
Practice Address - Phone:925-934-5088
Practice Address - Fax:925-934-4924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27008111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0270080OtherBLUE SHIELD
CADC0270080OtherBLUE SHIELD
CADC0270081Medicare ID - Type Unspecified