Organization
COMPLETE SPINE AND WELLNESS GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY EBERHART DC, QME (CEO)
(949) 650-4362
Entity
Organization
Contact information
Practice address
1640 NEWPORT BLVD STE 220, COSTA MESA, CA 92627-3786
(949) 650-4362
(949) 650-4366
Mailing address
1640 NEWPORT BLVD STE 220, COSTA MESA, CA 92627-3786
(949) 650-4362
(949) 650-4366
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
DC26382
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639319924
NPI
CA
Enumeration date
05/03/2007
Last updated
12/11/2012
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