Healthcare Provider Details

I. General information

NPI: 1962583773
Provider Name (Legal Business Name): STOKES CHIROPRACTIC OFFICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 08/26/2010
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

15550 ROCKFIELD BLVD B220
IRVINE CA
92618-2720
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: MARK R STOKES VI
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 562-497-8787