Healthcare Provider Details

I. General information

NPI: 1386172757
Provider Name (Legal Business Name): JOSHUA AND JACOB PAREDES CHIROPRACTIC CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PACIFIC COAST HWY STE 200
SEAL BEACH CA
90740
US

IV. Provider business mailing address

600 PACIFIC COAST HWY STE 200
SEAL BEACH CA
90740-6600
US

V. Phone/Fax

Practice location:
  • Phone: 714-585-2937
  • Fax:
Mailing address:
  • Phone: 714-585-2937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number33320
License Number StateCA

VIII. Authorized Official

Name: JOSHUA DAVID PAREDES
Title or Position: CEO
Credential: D.C.
Phone: 714-585-2937