GLASS CHIROPRACTIC CORPORATION (NPI# 1407462062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407462062 |
| Entity Type | Organization |
| Organization Name | GLASS CHIROPRACTIC CORPORATION |
| Practice Address |
22672 Lambert St Ste 601 Lake Forest CA 92630-1613 |
| Practice Telephone | 9492735935 |
| Mailing Telephone | 9492735935 |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-18 |
| Authorized Official Name | DUSTIN RAY GLASS (OWNER) |
| Authorized Official Telephone | 9492735935 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LICENSE | 28953 | 01 |
| Other Name | Type Code |
|---|---|
| HealthSource of Lake Forest | Doing Business As Name - Organization |
| Street Address |
22672 LAMBERT ST STE 601 |
| City | LAKE FOREST |
| State | CA |
| Zip Code | 92630-1613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194370338 | Ashlee Nicole-morton Sourapas | Midwife | 22672 Lambert Street, Suite 611, Lake Forest, CA 92630 | 2019-08-05 |
| 1134784879 | Scott Mach Enterprises | Custodial Care Facility | 23235 Cavanaugh Road, Lake Forest, CA 92630 | 2019-05-08 |
| 1992368930 | James Daniel Ticorat | Pharmacist | 25051 Calle Arenal, Lake Forest, CA 92630 | 2019-04-16 |
| 1770058349 | Tara L Anderson | Physician Assistant | 22365 El Toro Rd Unit 310, Lake Forest, CA 92630 | 2018-10-10 |
| 1659846855 | Song W. Jung. Dds. Inc | Dentist | 23361 El Toro Rd, Ste 105, Lake Forest, CA 92630 | 2018-10-04 |
| 1326520867 | Katherine Marie Billings | Speech-Language Pathologist | 25454 Navajo, Lake Forest, CA 92630 | 2018-08-31 |
| 1205339611 | Orange County Physiotherapy Services, P.C. | Physical Therapist | 22821 Aspan St., #100, Lake Forest, CA 92630 | 2018-03-12 |
| 1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
| 1750800132 | Jessica Aguilar | Marriage & Family Therapist | 21153 Calle De Paseo, Lake Forest, CA 92630 | 2017-09-16 |
| 1275072589 | Anhtu Wu | Pharmacist | 23182 Vista Way, Lake Forest, CA 92630 | 2017-02-20 |
| Find all providers in zip 92630 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962036616 | Lane N Tran | Chiropractor | 26242 Dimension Dr Ste 150, Lake Forest, CA 92630-7811 | 2020-03-02 |
| 1851931109 | Spine & Wellness Clinic, Inc. | Chiropractor | 775 N Bank Lane Suite 101, Lake Forest, IL 60045 | 2020-01-14 |
| 1467942573 | Nicholas Deliberato | Chiropractor | 22706 Aspan St Ste 702, Lake Forest, CA 92630-1641 | 2018-05-14 |
| 1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
| 1831583236 | Farangis Sabeti-kolahi Chiropractic, Inc. | Chiropractor | 22762 Aspen St Ste 205, Lake Forest, CA 92630-1604 | 2015-03-24 |
| 1437440047 | Kari Leigh Young | Chiropractor | 23101 Lake Center Dr Ste 110, Lake Forest, CA 92630-2882 | 2011-04-29 |
| 1154629699 | Straw Chiropractic Corp | Chiropractor | 23101 Lake Center Dr Ste 101, Lake Forest, CA 92630-2898 | 2011-03-08 |
| 1720385065 | Chi Therapy Center | Chiropractor | 24531 Trabuco Rd Ste C&d, Lake Forest, CA 92630-2162 | 2011-02-23 |
| 1265739718 | Christian Chee Chiropractic Inc | Chiropractor | 20671 Lake Forest Dr, Ste B-102, Lake Forest, CA 92630-7746 | 2011-02-18 |
| 1942505870 | Alternative Medicine & Natural Therapy Institute, A Professional Corp. | Chiropractor | 24531 Trabuco Rd, Suite #c, Lake Forest, CA 92630-2162 | 2011-01-25 |
| Find all providers in LAKE FOREST | ||||
| City | LAKE FOREST |
| Zip Code | 92630 |
Please comment or provide details below to improve the information on GLASS CHIROPRACTIC CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.