Provider Demographics
NPI:1881991750
Name:GARCIA & KAMBOURAKIS CHIROPRACTIC, INC
Entity type:Organization
Organization Name:GARCIA & KAMBOURAKIS CHIROPRACTIC, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-723-0702
Mailing Address - Street 1:128 AGATE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:BALBOA ISLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92662-1085
Mailing Address - Country:US
Mailing Address - Phone:949-723-0702
Mailing Address - Fax:949-723-0026
Practice Address - Street 1:128 AGATE AVE STE C
Practice Address - Street 2:
Practice Address - City:BALBOA ISLAND
Practice Address - State:CA
Practice Address - Zip Code:92662-1085
Practice Address - Country:US
Practice Address - Phone:949-723-0702
Practice Address - Fax:949-723-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-28103111N00000X
CAOT-5678225X00000X
CADC-31351111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty