Provider Demographics
NPI:1366824062
Name:MUFFOLETTO CHIROPRACTIC INC
Entity Type:Organization
Organization Name:MUFFOLETTO CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MUFFOLETTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-964-5100
Mailing Address - Street 1:17922 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5039
Mailing Address - Country:US
Mailing Address - Phone:714-964-5100
Mailing Address - Fax:714-964-5126
Practice Address - Street 1:17922 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5039
Practice Address - Country:US
Practice Address - Phone:714-964-5100
Practice Address - Fax:714-964-5126
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MUFFOLETTO CHIROPRACTIC INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-18
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty