Provider Demographics
NPI:1114052735
Name:AFFINITY CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:AFFINITY CHIROPRACTIC CENTER
Other - Org Name:HINER AND KARLIC CHIROPRACTIC INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:HINER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-544-8884
Mailing Address - Street 1:3565 S HIGUERA ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7339
Mailing Address - Country:US
Mailing Address - Phone:805-544-8884
Mailing Address - Fax:805-548-0055
Practice Address - Street 1:3565 S HIGUERA ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7339
Practice Address - Country:US
Practice Address - Phone:805-544-8884
Practice Address - Fax:805-548-0055
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HINER AND KARLIC CHIROPRACTIC, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-22
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24721111N00000X
CADC24865111N00000X
CA973155111NI0013X, 111NI0013X
CA969959111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1932143674OtherNPI JEFFREY HINER
1306873104OtherNPI SANDRA KARLIC-HINER
CADC34318OtherSTATE LIC.
CA1588130983OtherNPI VALERIE LYON
CADC24865OtherSTATE LICENSE
CADC24721OtherSTATE LICENSE
CADC24721OtherSTATE LICENSE
CADC24865OtherSTATE LICENSE
CADC24721OtherSTATE LICENSE
1932143674OtherNPI JEFFREY HINER
CADC24721Medicare PIN