Healthcare Provider Details

I. General information

NPI: 1861432858
Provider Name (Legal Business Name): JOSEPH M. ZAPPALA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2664 NEWPORT BLVD
COSTA MESA CA
92627-4641
US

IV. Provider business mailing address

2664 NEWPORT BLVD
COSTA MESA CA
92627-4641
US

V. Phone/Fax

Practice location:
  • Phone: 949-631-5226
  • Fax: 949-631-8538
Mailing address:
  • Phone: 949-631-5226
  • Fax: 949-631-8538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number20450
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: