Healthcare Provider Details

I. General information

NPI: 1497079396
Provider Name (Legal Business Name): KEVIN MICHAEL PIERCE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2010
Last Update Date: 03/21/2010
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

16200 AMBER VALLEY DR
WHITTIER CA
90604-4051
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number31605
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number31605
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: