Provider Demographics
NPI:1255724126
Name:UPLAND SPINE & REHABILITATION CHIROPRACTIC CENTER GARCIA INC
Entity type:Organization
Organization Name:UPLAND SPINE & REHABILITATION CHIROPRACTIC CENTER GARCIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:SALOMON
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-746-7077
Mailing Address - Street 1:1125 E 16TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-9180
Mailing Address - Country:US
Mailing Address - Phone:909-297-3531
Mailing Address - Fax:909-297-3004
Practice Address - Street 1:1125 E 16TH ST STE 4
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91784-9180
Practice Address - Country:US
Practice Address - Phone:909-297-3531
Practice Address - Fax:909-297-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-16
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32148111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty