Provider Demographics
NPI:1912036310
Name:HUBKA CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:HUBKA CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBKA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-796-2639
Mailing Address - Street 1:2623 E FOOTHILL BLVD
Mailing Address - Street 2:105
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3466
Mailing Address - Country:US
Mailing Address - Phone:626-796-2639
Mailing Address - Fax:626-796-2673
Practice Address - Street 1:2623 E FOOTHILL BLVD
Practice Address - Street 2:105
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3466
Practice Address - Country:US
Practice Address - Phone:626-796-2639
Practice Address - Fax:626-796-2673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20232111N00000X
CAAC6509171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty