Provider Demographics
NPI:1932282365
Name:CAMPBELL CHIROPRACTIC INC
Entity Type:Organization
Organization Name:CAMPBELL CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CAMPBELL CHIROPRACTIC INC
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-364-6888
Mailing Address - Street 1:27882 FORBES RD
Mailing Address - Street 2:STE 100
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1267
Mailing Address - Country:US
Mailing Address - Phone:949-364-6888
Mailing Address - Fax:949-364-6333
Practice Address - Street 1:27882 FORBES RD
Practice Address - Street 2:STE 100
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1267
Practice Address - Country:US
Practice Address - Phone:949-364-6888
Practice Address - Fax:949-364-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-21
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty