Provider Demographics
NPI:1922475748
Name:HALL INTEGRATIVE HEALTH AND CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HALL INTEGRATIVE HEALTH AND CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-903-2131
Mailing Address - Street 1:4100 CAMPUS DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1929
Mailing Address - Country:US
Mailing Address - Phone:949-478-0801
Mailing Address - Fax:801-729-9218
Practice Address - Street 1:9988 HIBERT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-2480
Practice Address - Country:US
Practice Address - Phone:858-461-8898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22408111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty