Provider Demographics
NPI:1184689945
Name:BALSIMELLI, DENISE (DC)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:BALSIMELLI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:BALSIMELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2900 BRISTOL STREET
Mailing Address - Street 2:BUILDING J SUITE 108
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626
Mailing Address - Country:US
Mailing Address - Phone:714-343-4548
Mailing Address - Fax:714-556-3040
Practice Address - Street 1:2900 BRISTOL STREET
Practice Address - Street 2:BUILDING J SUITE 108
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626
Practice Address - Country:US
Practice Address - Phone:714-343-4548
Practice Address - Fax:714-556-3040
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-17
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21893111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor