Healthcare Provider Details

I. General information

NPI: 1376823971
Provider Name (Legal Business Name): KAMALDEEP SINGH CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SUPERIOR AVE SUITE 350
NEWPORT BEACH CA
92663-2716
US

IV. Provider business mailing address

10 SPRINGWOOD
IRVINE CA
92604-4602
US

V. Phone/Fax

Practice location:
  • Phone: 949-548-1188
  • Fax: 949-548-1177
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC30624
License Number StateCA

VIII. Authorized Official

Name: DR. KAMALDEEP SINGH
Title or Position: CEO
Credential: D.C.
Phone: 949-548-1188