FORM FUNCTION INC (NPI# 1548758071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548758071 |
| Entity Type | Organization |
| Organization Name | FORM FUNCTION INC |
| Practice Address |
1966 Hacienda Dr Vista CA 92081-6025 |
| Mailing Address |
Po Box 1176 Cardiff CA 92007-7176 |
| Practice Telephone | 3105286276 |
| Mailing Telephone | 8585097999 |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2018-04-30 |
| Authorized Official Name | NICHOLAS GARCIA (OWNER/CHIROPRACTOR) |
| Authorized Official Telephone | 3105286276 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Street Address |
1966 HACIENDA DR |
| City | VISTA |
| State | CA |
| Zip Code | 92081-6025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548896202 | Maritza Mercado | Behavior Technician | 1926 Civic Center Dr Suite B, Vista, CA 92081 | 2020-03-13 |
| 1417599267 | Cherelle Artise Lewis | Behavior Technician | 1926 Via Centre Drive, Suite B, Vista, CA 92081 | 2019-10-14 |
| 1194101295 | Mary Stewart | Physical Therapist | 1515 S Melrose Dr, Vista, CA 92081 | 2015-07-31 |
| 1184069122 | Houri Fatourachi, Dds Inc | Dentist | 2325 S Melrose Dr., Vista, CA 92081 | 2013-05-03 |
| 1821377037 | Mori Medical Equipment Inc | Durable Medical Equipment & Medical Supplies | 2320 La Mirada Dr, Vista, CA 92081 | 2011-08-05 |
| 1497068563 | Gerald Francis Moore | Dentist | 610 S. Melrose Dr, Vista, CA 92081 | 2010-07-19 |
| 1316274749 | Mahtab Saadatmandi | Dentist | 2311 S. Melrose Dr., Vista, CA 92081 | 2009-11-05 |
| 1760650808 | Edward George Dougherty | Occupational Therapy Assistant | 1579 Wellington Lane, 51, Vista, CA 92081 | 2008-02-12 |
| 1831398676 | Longs Drug Stores California LLC | Pharmacy | 635 S Melrose Dr, Vista, CA 92081 | 2007-07-12 |
| 1346462231 | Houri Fatourachi | Dentist | 2325 South Melrose Drive, Vista, CA 92081 | 2007-05-02 |
| Find all providers in zip 92081 | ||||
| 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 |
|---|---|---|---|---|
| 1336432426 | Kiet Van Tran | Chiropractor | 2305 S Melrose Dr, Ste #107, Vista, CA 92081-8752 | 2011-05-23 |
| 1427371830 | Kyle Tetz Chiropractic Inc | Chiropractor | 510 Hacienda Dr Ste 107, Vista, CA 92081-6639 | 2010-03-12 |
| 1063747517 | Nima Arabani | Chiropractor | 1611 S Melrose Dr # A160, Vista, CA 92081-5407 | 2009-10-15 |
| 1508044181 | Thomas B Clark | Chiropractor | 2092 Casa De Vereda, Vista, CA 92084-4223 | 2008-02-05 |
| 1407036684 | Gregory Herbert Ward | Chiropractor | 933 Vale Terrace Dr Ste C, Vista, CA 92084-5213 | 2007-11-06 |
| 1194912873 | Thoralinda S. Soyland | Chiropractor | 1250 S. Santa Fe Avenue, Suite O, Vista, CA 92084-7273 | 2007-09-26 |
| 1710179510 | Jill D Chapman Chiropractic Apc | Chiropractor | 410 S Santa Fe Ave Ste 201, Vista, CA 92084-6163 | 2007-08-15 |
| 1316140551 | Kelly Marie Gibson | Chiropractor | 1929 W Vista Way, Suite C, Vista, CA 92083 | 2007-06-06 |
| 1982811493 | John Richard Clark II | Chiropractor | 750 Sycamore Ave Ste B, Vista, CA 92083-7912 | 2007-05-16 |
| 1063627701 | Albert Lawrence Rassel | Chiropractor | 981 Escondido Ave, Vista, CA 92083-5243 | 2007-05-14 |
| Find all providers in VISTA | ||||
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| 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.