Healthcare Provider Details

I. General information

NPI: 1447226592
Provider Name (Legal Business Name): CLIFF TAO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 08/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1381 S WALNUT ST UNIT 2906
ANAHEIM CA
92802-2270
US

IV. Provider business mailing address

PO BOX 9161
ANAHEIM CA
92812-7161
US

V. Phone/Fax

Practice location:
  • Phone: 714-876-1126
  • Fax:
Mailing address:
  • Phone: 714-876-1126
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number27648
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License NumberDC-27648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: