1588891014 NPI number — BUNCH CHIROPRACTIC INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588891014 NPI number — BUNCH CHIROPRACTIC INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUNCH CHIROPRACTIC INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588891014
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3951 S PLAZA DR
Provider Second Line Business Mailing Address:
SUITE 150
Provider Business Mailing Address City Name:
SANTA ANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92704-7461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-751-8570
Provider Business Mailing Address Fax Number:
714-751-8568

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3951 S PLAZA DR
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92704-7461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-751-8570
Provider Business Practice Location Address Fax Number:
714-751-8568
Provider Enumeration Date:
06/11/2009

Additional Information

Authorized Official

Authorized Official Last Name:
BUNCH
Authorized Official First Name:
RAYMOND
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
714-751-8570

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC20929 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DC0209290 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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