Healthcare Provider Details

I. General information

NPI: 1881764322
Provider Name (Legal Business Name): SOUTHERN CALIFORNIA UNIVERSITY OF HEALTH SCIENCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16200 E AMBER VALLEY DRIVE
WHITTIER CA
90604
US

IV. Provider business mailing address

16200 E AMBER VALLEY DRIVE
WHITTIER CA
90604
US

V. Phone/Fax

Practice location:
  • Phone: 562-947-8755
  • Fax: 562-902-3332
Mailing address:
  • Phone: 562-947-8755
  • Fax: 562-902-3332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MELISSA ANNE NAGARE
Title or Position: CHIEF CLINICAL OFFICER
Credential:
Phone: 562-947-3386