Healthcare Provider Details

I. General information

NPI: 1114101953
Provider Name (Legal Business Name): DAVID AHRENS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

629 CAMINO DE LOS MARES SUITE 104
SAN CLEMENTE CA
92673-2829
US

IV. Provider business mailing address

629 CAMINO DE LOS MARES SUITE 104
SAN CLEMENTE CA
92673-2829
US

V. Phone/Fax

Practice location:
  • Phone: 714-240-1334
  • Fax: 949-240-4434
Mailing address:
  • Phone: 714-240-1334
  • Fax: 949-240-4434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC15856
License Number StateCA

VIII. Authorized Official

Name: DR. DAVID AHRENS
Title or Position: DAVID AHRENS/CHIROPRACTOR
Credential: D.C.
Phone: 714-240-1334