Organization
PREMIER HEALTH CARE CHIROPRACTIC & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY SHAPERO D.C. (EXECUTIVE DIRECTOR)
(949) 492-7488
Entity
Organization
Contact information
Practice address
1238 PUERTA DEL SOL STE 1A, 1A, SAN CLEMENTE, CA 92673-6310
(949) 492-7488
(949) 492-6658
Mailing address
1001 AVENIDA PICO, SUITE C460, SAN CLEMENTE, CA 92673-6957
(949) 492-7488
(949) 492-6658
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DJ451A
MEDICARE PTAN
CA
Enumeration date
12/29/2010
Last updated
12/08/2016
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