Provider Demographics
NPI:1902507213
Name:AMSTUTZ CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:AMSTUTZ CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:AMSTUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCSP, RTP, CSCS
Authorized Official - Phone:949-465-0770
Mailing Address - Street 1:2072 ORCHARD DR STE C
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-0785
Mailing Address - Country:US
Mailing Address - Phone:949-465-0770
Mailing Address - Fax:949-298-5612
Practice Address - Street 1:2072 ORCHARD DR STE C
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-0785
Practice Address - Country:US
Practice Address - Phone:949-465-0770
Practice Address - Fax:949-298-5612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-14
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1184083057OtherANDREW ADAMS