Healthcare Provider Details

I. General information

NPI: 1245614767
Provider Name (Legal Business Name): HOWARD B FOX CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2015
Last Update Date: 07/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27131 CALLE ARROYO SUITE 1702
SAN JUAN CAPISTRANO CA
92675-2700
US

IV. Provider business mailing address

27131 CALLE ARROYO SUITE 1702
SAN JUAN CAPISTRANO CA
92675-2700
US

V. Phone/Fax

Practice location:
  • Phone: 949-489-2920
  • Fax: 949-489-0897
Mailing address:
  • Phone: 949-489-2920
  • Fax: 949-489-0897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: HOWARD B FOX
Title or Position: PRESIDENT
Credential: D. C.
Phone: 949-489-2920