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Organization
IL HWAN PARK CHIROPRACTIC CLINIC
Active
Organization
IL HWAN PARK CHIROPRACTIC CLINIC
Active
Other names
BEST SPINE CHIROPRACTIC CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA PHAM (ADMINISTRATOR)
(408) 249-0422
Entity
Organization
Contact information
Practice address
4155 MOORPARK AVENUE, SUITE 1, SAN JOSE, CA 95117
(408) 249-0422
(408) 249-0430
Mailing address
4155 MOORPARK AVENUE, SUITE 1, SAN JOSE, CA 95117
(408) 249-0422
(408) 249-0430
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC31167
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA123187
MEDICARE PTAN
CA
01
—
CA123188
PTAN
CA
Enumeration date
07/27/2015
Last updated
07/27/2015
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