Provider Demographics
NPI:1982042123
Name:ZAVACKI CHIROPRACTIC HEALTH MANAGEMENT INC
Entity Type:Organization
Organization Name:ZAVACKI CHIROPRACTIC HEALTH MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PETE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAVACKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-272-2773
Mailing Address - Street 1:438 CAMINO DEL RIO S
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3509
Mailing Address - Country:US
Mailing Address - Phone:619-272-2773
Mailing Address - Fax:619-295-3825
Practice Address - Street 1:438 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3509
Practice Address - Country:US
Practice Address - Phone:619-272-2773
Practice Address - Fax:619-295-3825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty