Healthcare Provider Details

I. General information

NPI: 1942521745
Provider Name (Legal Business Name): FRANKIE D SCOTTCANOVA DC A CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 05/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33080 NIGUEL RD
MONARCH BEACH CA
92629-4051
US

IV. Provider business mailing address

33080 NIGUEL RD
MONARCH BEACH CA
92629-4051
US

V. Phone/Fax

Practice location:
  • Phone: 949-492-5500
  • Fax: 949-492-5509
Mailing address:
  • Phone: 949-492-5500
  • Fax: 949-492-5509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number20538
License Number StateCA

VIII. Authorized Official

Name: DR. FRANKIE DOREEN SCOTT-CANOVA
Title or Position: PRESIDENT
Credential: D.C.
Phone: 949-492-5500