Provider Demographics
NPI:1447705157
Name:DISABATINO CHIROPRACTIC AND REHAB INC
Entity type:Organization
Organization Name:DISABATINO CHIROPRACTIC AND REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:DISABATINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:619-322-4626
Mailing Address - Street 1:3456 CAMINO DEL RIO N STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1714
Mailing Address - Country:US
Mailing Address - Phone:619-322-4626
Mailing Address - Fax:619-923-2873
Practice Address - Street 1:3456 CAMINO DEL RIO N STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1714
Practice Address - Country:US
Practice Address - Phone:619-322-4626
Practice Address - Fax:619-923-2873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty