| Organization Name: | SAN JOAQUIN WELLNESS & MEDICAL GROUP, INC |
| NPI Number: | 1679673719 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VINCENT STEVEN BOOTH (CLINIC DIRECTOR) |
| Mailing Address: | 1201 24th St B-200 Bakersfield |
| State: | CA US |
| Postal Code: | 933012310 |
| Phone Number: | 6613244431 |
| Fax Number: | 6613245616 |
| NPI Enumeration Date: | 09/25/2006 |
| NPI Last Update Date: | 04/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111N00000X |
| License Number: | DC0143200 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Chiropractic Providers |
| Taxonomy Classification: | Chiropractor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | 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. |