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Organization

MY CENTER FOR CHIROPRACTIC & ANTI-AGING MEDICINE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID C MANAGO DC (PRESIDENT)
(949) 364-5656
Entity
Organization

Contact information

Practice address
26990 CROWN VALLEY PKWY, SUITE C, MISSION VIEJO, CA 92691-6548
(949) 364-5656
Mailing address
26990 CROWN VALLEY PKWY, SUITE C, MISSION VIEJO, CA 92691-6548
(949) 364-5656

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC14686
CA
208D00000X
General Practice Physician
Primary
A60570
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A605700
BCBS
CA
01
DC0146860
BCBS
CA
Enumeration date
04/15/2008
Last updated
12/03/2008
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