Healthcare Provider Details

I. General information

NPI: 1487757340
Provider Name (Legal Business Name): JOHN M SELLERS DC, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 12/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16200 AMBER VALLEY DR
WHITTIER CA
90604-4051
US

IV. Provider business mailing address

PO BOX 1951
HUNTINGTON BEACH CA
92647-1951
US

V. Phone/Fax

Practice location:
  • Phone: 562-943-7125
  • Fax:
Mailing address:
  • Phone: 714-679-8513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC24596
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number13368
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: