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Organization

DE DUBOVAY CHIROPRACTIC, INC.

Active
Other names
Advanced Wellness Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK DE DUBOVAY D.C. (PRESIDENT)
(562) 795-6680
Entity
Organization

Contact information

Practice address
14340 BOLSA CHICA RD STE G, WESTMINSTER, CA 92683
(562) 795-6680
(562) 799-9575
Mailing address
14340 BOLSA CHICA RD STE G, WESTMINSTER, CA 92683-4868
(562) 795-6680
(562) 799-9575

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC16862
CA
111N00000X
Chiropractor
Primary
DC17394
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ZZZ61802Z
BLUE SHIELD NO.
CA
Enumeration date
06/25/2006
Last updated
08/27/2018
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