Healthcare Provider Details

I. General information

NPI: 1225335813
Provider Name (Legal Business Name): MR. JOHN DAVID BYRNE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 W KATELLA AVE STE 150
ORANGE CA
92867-3432
US

IV. Provider business mailing address

1855 W KATELLA AVE STE 150
ORANGE CA
92867-3432
US

V. Phone/Fax

Practice location:
  • Phone: 714-712-8340
  • Fax:
Mailing address:
  • Phone: 562-293-8312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: