Basic Information
| Provider Information | |||||||||
| NPI: | 1891701413 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PACELLI | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | |||||||||
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| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17251 17TH ST STE A | ||||||||
| Address2: | |||||||||
| City: | TUSTIN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927801963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148322273 | ||||||||
| FaxNumber: | 7148322272 | ||||||||
| Practice Location | |||||||||
| Address1: | 17251 17TH ST STE A | ||||||||
| Address2: | |||||||||
| City: | TUSTIN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927801963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7148322273 | ||||||||
| FaxNumber: | 7148322272 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2006 | ||||||||
| LastUpdateDate: | 06/19/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | DC30257 | CA | Y | Chiropractic Providers | Chiropractor |
No ID Information.