Provider Demographics
NPI:1952448664
Name:CZAPLA, MICHAEL ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROBERT
Last Name:CZAPLA
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 1:2675 IRVINE AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-4653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2675 IRVINE AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-4653
Practice Address - Country:US
Practice Address - Phone:949-631-0200
Practice Address - Fax:949-631-2050
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29276111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC 29276OtherCA CHIROPRACTIC LICENSE #