Provider Demographics
NPI:1952575821
Name:JOSEPH PACELLI CHIROPRACTIC
Entity Type:Organization
Organization Name:JOSEPH PACELLI CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PACELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-771-5363
Mailing Address - Street 1:3533 E CHAPMAN AVE
Mailing Address - Street 2:N-P
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-3854
Mailing Address - Country:US
Mailing Address - Phone:714-771-5363
Mailing Address - Fax:714-771-5360
Practice Address - Street 1:3533 E CHAPMAN AVE
Practice Address - Street 2:N-P
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-3854
Practice Address - Country:US
Practice Address - Phone:714-771-5363
Practice Address - Fax:714-771-5360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30257111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC30257Medicare UPIN
CADC30257Medicare PIN