Healthcare Provider Details

I. General information

NPI: 1487735288
Provider Name (Legal Business Name): MARK R STOKES D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 10/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 PALO VERDE AVE 204
LONG BEACH CA
90808-4132
US

IV. Provider business mailing address

15520 ROCKFIELD BLVD A200
IRVINE CA
92618-6705
US

V. Phone/Fax

Practice location:
  • Phone: 562-497-8787
  • Fax: 562-497-8790
Mailing address:
  • Phone: 949-598-9999
  • Fax: 949-598-9990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC10691
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: