Healthcare Provider Details

I. General information

NPI: 1013919000
Provider Name (Legal Business Name): ANTONIO TRONO FERNANDEZ IV D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12030 RIVERSIDE DR
VALLEY VILLAGE CA
91607-3749
US

IV. Provider business mailing address

12030 RIVERSIDE DR
VALLEY VILLAGE CA
91607-3749
US

V. Phone/Fax

Practice location:
  • Phone: 323-848-6997
  • Fax: 323-848-6998
Mailing address:
  • Phone: 323-848-6997
  • Fax: 323-848-6998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number27059
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: