Healthcare Provider Details

I. General information

NPI: 1245062611
Provider Name (Legal Business Name): WAYNE HUO CHIROPRACTIC CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2024
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 PUENTE AVE STE C
BALDWIN PARK CA
91706-5994
US

IV. Provider business mailing address

1845 S LANG AVE
WEST COVINA CA
91790-4454
US

V. Phone/Fax

Practice location:
  • Phone: 626-552-5880
  • Fax:
Mailing address:
  • Phone: 626-552-5880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MR. WAYNE HUO
Title or Position: CEO
Credential: DC
Phone: 626-552-5880