International Chiropractic Centre

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

DC24364 Issued in CA

Legal business name

INTERNATIONAL CHIROPRACTIC CENTRE

Practice address

2588 Mission St
Suite 201
San Francisco, CA 94110-2592

Phone

(415) 695-0654

NPI assigned

Dec 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Manuel M. Fonseca, DC

Title

Director

Phone

(415) 695-0654

Specialties & licenses 3

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1043370265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2588 MISSION ST",
            "address_2": "SUITE 201",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102592",
            "telephone_number": "415-695-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2588 MISSION ST",
            "address_2": "SUITE 201",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102592",
            "telephone_number": "415-695-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL CHIROPRACTIC CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "FONSECA",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "415-695-0654",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24364",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "DC24364",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC24364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC0243640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in San Francisco, CA
• Sports Physician Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.