Healthcare Provider Details

I. General information

NPI: 1538479100
Provider Name (Legal Business Name): BIRD CHIROPRACTIC CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8036 3RD, ST. SUITE 103
DOWNEY CA
90241
US

IV. Provider business mailing address

8036 3RD, ST. SUITE 103
DOWNEY CA
90241
US

V. Phone/Fax

Practice location:
  • Phone: 562-658-7956
  • Fax: 800-828-9183
Mailing address:
  • Phone: 562-658-7956
  • Fax: 800-828-9183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC24994
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License NumberDC24994
License Number StateCA

VIII. Authorized Official

Name: DR. JOEL WALTER BIRD
Title or Position: OWNER / CEO
Credential: D.C.
Phone: 562-658-7956