Provider Demographics
NPI:1851631121
Name:APEX CHIROPRACTIC & SCI WELLNESS CENTER
Entity Type:Organization
Organization Name:APEX CHIROPRACTIC & SCI WELLNESS CENTER
Other - Org Name:APEX CHIROPRACTIC & SCI WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:DEL CID
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-488-0016
Mailing Address - Street 1:33159 CAMINO CAPISTRANO
Mailing Address - Street 2:SUITE D
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-4827
Mailing Address - Country:US
Mailing Address - Phone:949-488-0016
Mailing Address - Fax:949-488-0507
Practice Address - Street 1:33159 CAMINO CAPISTRANO
Practice Address - Street 2:SUITE D
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-4827
Practice Address - Country:US
Practice Address - Phone:949-488-0016
Practice Address - Fax:949-488-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-25
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty