Provider Demographics
NPI:1235477837
Name:SYN-CARE WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:SYN-CARE WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMENIC
Authorized Official - Middle Name:
Authorized Official - Last Name:DIDOMENICANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-325-3044
Mailing Address - Street 1:3445 PACIFIC COAST HWY
Mailing Address - Street 2:300A
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6660
Mailing Address - Country:US
Mailing Address - Phone:310-325-3044
Mailing Address - Fax:310-325-3041
Practice Address - Street 1:3445 PACIFIC COAST HIGHWAY
Practice Address - Street 2:300A
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6660
Practice Address - Country:US
Practice Address - Phone:310-325-3044
Practice Address - Fax:310-325-3041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27596111N00000X
CADC19629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty