Organization
COMPLETE SPINE AND WELLNESS GROUP, INC
Active
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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