Healthcare Provider Details

I. General information

NPI: 1396684767
Provider Name (Legal Business Name): DELYN MOUA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4753 FIRESTONE BLVD
SOUTH GATE CA
90280-3448
US

IV. Provider business mailing address

16434 WHITTIER BLVD UNIT 1
WHITTIER CA
90603-2465
US

V. Phone/Fax

Practice location:
  • Phone: 323-310-2217
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC37394
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: