Provider Demographics
NPI:1508889841
Name:GASPAREVICH, JOHN ADAM (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ADAM
Last Name:GASPAREVICH
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 1:9673 SIERRA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-2424
Mailing Address - Country:US
Mailing Address - Phone:909-829-8722
Mailing Address - Fax:909-829-4402
Practice Address - Street 1:9673 SIERRA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-2424
Practice Address - Country:US
Practice Address - Phone:909-829-8722
Practice Address - Fax:909-829-4402
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27913111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor