Provider Demographics
NPI:1881080562
Name:GATSINARIS CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:GATSINARIS CHIROPRACTIC, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VASILI
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GATSINARIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-263-9003
Mailing Address - Street 1:15520 ROCKFIELD BLVD STE A200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-6705
Mailing Address - Country:US
Mailing Address - Phone:495-989-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:17811 SKY PARK CIR
Practice Address - Street 2:STE. E
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6109
Practice Address - Country:US
Practice Address - Phone:949-263-9003
Practice Address - Fax:949-263-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC32332111N00000X
CADC31706111N00000X
CADC28232111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty