Organization
INTERNATIONAL CHIROPRACTIC CENTRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL M. FONSECA DC (DIRECTOR)
(415) 695-0654
Entity
Organization
Contact information
Practice address
2588 MISSION ST, SUITE 201, SAN FRANCISCO, CA 94110-2592
(415) 695-0654
Mailing address
2588 MISSION ST, SUITE 201, SAN FRANCISCO, CA 94110-2592
(415) 695-0654
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC24364
CA
111NR0400X
Rehabilitation Chiropractor
DC24364
CA
111NS0005X
Sports Physician Chiropractor
Primary
DC24364
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DC0243640
—
CA
Enumeration date
12/11/2006
Last updated
09/11/2025
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