Provider Demographics
NPI:1841177573
Name:RIVERSIDE CHIROPRACTIC CENTER MAK PC
Entity type:Organization
Organization Name:RIVERSIDE CHIROPRACTIC CENTER MAK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHUN KEUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:MAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-895-1913
Mailing Address - Street 1:3657 VAN BUREN BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-4249
Mailing Address - Country:US
Mailing Address - Phone:951-906-0101
Mailing Address - Fax:
Practice Address - Street 1:3657 VAN BUREN BLVD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-4249
Practice Address - Country:US
Practice Address - Phone:951-906-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHUN KEUNG MAK DC, QME, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes209800000XAllopathic & Osteopathic PhysiciansLegal MedicineGroup - Multi-Specialty