Healthcare Provider Details

I. General information

NPI: 1548633829
Provider Name (Legal Business Name): ANNE YEAKEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2015
Last Update Date: 11/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6234 E PACIFIC COAST HWY UNIT C
LONG BEACH CA
90803
US

IV. Provider business mailing address

5152 DUNBAR DR APT B
HUNTINGTON BEACH CA
92649-5186
US

V. Phone/Fax

Practice location:
  • Phone: 562-493-5600
  • Fax:
Mailing address:
  • Phone: 760-716-9293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number33317
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: