Healthcare Provider Details

I. General information

NPI: 1316455439
Provider Name (Legal Business Name): VAUGHAN CHIROPRACTIC AND WELLNESS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2018
Last Update Date: 01/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 KALMUS DR
COSTA MESA CA
92626-5988
US

IV. Provider business mailing address

151 KALMUS DR
COSTA MESA CA
92626-5988
US

V. Phone/Fax

Practice location:
  • Phone: 714-435-9355
  • Fax: 714-441-9323
Mailing address:
  • Phone: 714-435-9355
  • Fax: 714-441-9323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. KRISTI VAUGHAN
Title or Position: CEO
Credential: DC
Phone: 714-434-9355