Healthcare Provider Details

I. General information

NPI: 1821804345
Provider Name (Legal Business Name): MOORE SPINE CENTER& CHIROPRACTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PETERS CANYON RD STE 120
IRVINE CA
92606-1748
US

IV. Provider business mailing address

1 PETERS CANYON RD STE 120
IRVINE CA
92606-1748
US

V. Phone/Fax

Practice location:
  • Phone: 949-653-6777
  • Fax: 949-653-9951
Mailing address:
  • Phone: 949-653-6777
  • Fax: 949-653-9951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS KENT HOY
Title or Position: OWNER
Credential: DC
Phone: 562-230-7671