Healthcare Provider Details

I. General information

NPI: 1649469578
Provider Name (Legal Business Name): SIMPSON CHIROPRACTIC GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 E IMPERIAL HWY SUITE: 164
BREA CA
92821-6122
US

IV. Provider business mailing address

2500 E IMPERIAL HWY SUITE: 164
BREA CA
92821-6122
US

V. Phone/Fax

Practice location:
  • Phone: 714-255-9494
  • Fax: 714-255-1019
Mailing address:
  • Phone: 714-255-9494
  • Fax: 714-255-1019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC20405
License Number StateCA

VIII. Authorized Official

Name: DR. TODD R. SIMPSON
Title or Position: OWNER
Credential: DC
Phone: 714-255-9494