Healthcare Provider Details

I. General information

NPI: 1528188216
Provider Name (Legal Business Name): JAMES J. DEMARCO, D.C. A CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8840 WARNER AVE SUITE 201
FOUNTAIN VALLEY CA
92708-3232
US

IV. Provider business mailing address

8840 WARNER AVE SUITE 201
FOUNTAIN VALLEY CA
92708-3232
US

V. Phone/Fax

Practice location:
  • Phone: 714-848-3603
  • Fax: 714-848-3605
Mailing address:
  • Phone: 714-848-3603
  • Fax: 714-848-3605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC14902
License Number StateCA

VIII. Authorized Official

Name: DR. JAMES J DEMARCO
Title or Position: PRESIDENT
Credential: D.C.
Phone: 714-848-3603