Provider Demographics
NPI:1235128810
Name:GATSINARIS, VASILI JOHN (DC)
Entity Type:Individual
Prefix:
First Name:VASILI
Middle Name:JOHN
Last Name:GATSINARIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17811 SKY PARK CIR
Mailing Address - Street 2:SUITE E
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6109
Mailing Address - Country:US
Mailing Address - Phone:949-263-9003
Mailing Address - Fax:949-263-9002
Practice Address - Street 1:17811 SKY PARK CIR
Practice Address - Street 2:SUITE E
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6109
Practice Address - Country:US
Practice Address - Phone:949-263-9003
Practice Address - Fax:949-263-9002
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor