International Chiropractic Centre
Chiropractor, Sports Physician in San Francisco, CA. Organization (NPI-2).
NPI number1043370265
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1043370265
- Entity type
- Organization (NPI-2)
- Legal business name
- International Chiropractic Centre
- Organization subpart
- No
- Enumeration date
- Dec 11, 2006
- Last updated
- Sep 11, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111NS0005X | Chiropractor, Sports Physician | DC24364 | CA | Yes |
| 111N00000X | Chiropractor | DC24364 | CA | |
| 111NR0400X | Chiropractor, Rehabilitation | DC24364 | CA |
Practice location
2588 Mission StSuite 201
San Francisco, CA 94110-2592
Phone 415-695-0654
Mailing address
2588 Mission StSuite 201
San Francisco, CA 94110-2592
Phone 415-695-0654
Authorized official
Manuel M. Fonseca
Director
4156950654
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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