Healthcare Provider Details

I. General information

NPI: 1952551491
Provider Name (Legal Business Name): MATTHEW TODD ORMOND D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2008
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7561 CENTER AVE SUITE 15
HUNTINGTON BEACH CA
92647-3053
US

IV. Provider business mailing address

7561 CENTER AVE SUITE 15
HUNTINGTON BEACH CA
92647-3053
US

V. Phone/Fax

Practice location:
  • Phone: 714-745-7643
  • Fax: 888-317-1204
Mailing address:
  • Phone: 714-745-7643
  • Fax: 888-317-1204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC30977
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2008009305
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberCHIA-1309
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: