Healthcare Provider Details

I. General information

NPI: 1114495215
Provider Name (Legal Business Name): SWEIDAN CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 11/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16331 GOTHARD ST STE D
HUNTINGTON BEACH CA
92647-3664
US

IV. Provider business mailing address

16331 GOTHARD ST STE D
HUNTINGTON BEACH CA
92647-3664
US

V. Phone/Fax

Practice location:
  • Phone: 714-916-1451
  • Fax:
Mailing address:
  • Phone: 714-916-1451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: NESREIN SWEIDAN
Title or Position: OWNER/ PHYSICIAN
Credential: DC, LAC
Phone: 951-961-4174