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Organization
WINE COUNTRY CHIROPRACTIC MARK S. BANASIAK DC INC. A PROFESSIONAL CORP
Active
Organization
WINE COUNTRY CHIROPRACTIC MARK S. BANASIAK DC INC. A PROFESSIONAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK S. BANASIAK D.C. (DOCTOR OF CHIROPRACTIC)
(951) 587-2225
Entity
Organization
Contact information
Practice address
27555 YNEZ RD STE 350, TEMECULA, CA 92591-4688
(951) 587-2225
(951) 365-0027
Mailing address
29377 RANCHO CALIFORNIA RD, SUITE# 106, TEMECULA, CA 92591-5206
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC23625
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ63647Y
BLUE SHIELD
CA
Enumeration date
07/07/2010
Last updated
01/12/2024
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