Provider Demographics
NPI:1245307230
Name:UJKIC, GEORGE NICK (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:NICK
Last Name:UJKIC
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 1:630 S GLASSELL ST
Mailing Address - Street 2:#102
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866
Mailing Address - Country:US
Mailing Address - Phone:714-639-3935
Mailing Address - Fax:714-450-1029
Practice Address - Street 1:630 S GLASSELL ST
Practice Address - Street 2:#102
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866
Practice Address - Country:US
Practice Address - Phone:714-639-3935
Practice Address - Fax:714-450-1029
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA20015DC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC020015Medicare ID - Type Unspecified