Organization
VISICHIO CHIROPRACTIC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARIN MICHAEL VISICHIO D.C. (OWNER)
71488708023
Entity
Organization
Contact information
Practice address
714 ADAMS AVE, 209, HUNTINGTON BEACH, CA 92648-3267
(714) 887-8023
Mailing address
714 ADAMS AVE STE 209, HUNTINGTON BEACH, CA 92648-3267
(714) 887-8023
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
23395
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ62920Z
BLUE SHIELD
CA
Enumeration date
02/11/2008
Last updated
10/01/2010
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