Provider Demographics
NPI:1114495215
Name:SWEIDAN CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:SWEIDAN CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NESREIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:951-961-4174
Mailing Address - Street 1:16331 GOTHARD ST STE D
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3664
Mailing Address - Country:US
Mailing Address - Phone:714-916-1451
Mailing Address - Fax:
Practice Address - Street 1:16331 GOTHARD ST STE D
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3664
Practice Address - Country:US
Practice Address - Phone:714-916-1451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty