Healthcare Provider Details

I. General information

NPI: 1760179196
Provider Name (Legal Business Name): MORONES FLANNERY CHIROPRACTIC, PROF. CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 04/18/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W BASTANCHURY RD # 1D
FULLERTON CA
92835-2522
US

IV. Provider business mailing address

111 W BASTANCHURY RD # 1D
FULLERTON CA
92835-2522
US

V. Phone/Fax

Practice location:
  • Phone: 714-732-9888
  • Fax:
Mailing address:
  • Phone: 714-732-9888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. SEAN MICHAEL FLANNERY
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 714-732-9888