Healthcare Provider Details

I. General information

NPI: 1336427624
Provider Name (Legal Business Name): EMPLOYEE CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2011
Last Update Date: 09/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N. PARKCENTER DR STE 100
SANTA ANA CA
92705-3529
US

IV. Provider business mailing address

550 N PARKCENTER DR STE 100
SANTA ANA CA
92705-3529
US

V. Phone/Fax

Practice location:
  • Phone: 714-953-4322
  • Fax: 714-953-4327
Mailing address:
  • Phone: 714-953-4322
  • Fax: 714-953-4327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC31936
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberDC31936
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC8877
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT12770
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT12770
License Number StateCA
# 6
Primary TaxonomyY
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License NumberPT12770
License Number StateCA

VIII. Authorized Official

Name: MR. MICHAEL KOERNER
Title or Position: PARTNER
Credential: PT
Phone: 714-785-6573