Healthcare Provider Details

I. General information

NPI: 1558303313
Provider Name (Legal Business Name): CLARENCE ALEXANDER HUNTER III D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5345 IRWINDALE AVE
IRWINDALE CA
91706-2025
US

IV. Provider business mailing address

16702 VALLEY VIEW AVE
LA MIRADA CA
90638-5824
US

V. Phone/Fax

Practice location:
  • Phone: 626-960-5361
  • Fax: 626-337-0833
Mailing address:
  • Phone: 714-367-5360
  • Fax: 714-635-5428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC28679
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: