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General NPI Number Information
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NPI Number | 1013135094
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Entity Type | Organization
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Legal Business Name | MAI & PRASARNSUK, A CHIROPRACTIC CORP.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 710 S HARBOR BLVD
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City | SANTA ANA
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State | CA
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Zip | 92704-2337
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Country | US
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Telephone | 714-839-2300
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Fax | 714-839-2320
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Provider Business Mailing Address
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Address Line | 710 S HARBOR BLVD
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City | SANTA ANA
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State | CA
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Zip | 92704-2337
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Country | US
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Telephone | 714-839-2300
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Fax | 714-839-2320
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | TOLAN MAI
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Credential | D.C.
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Telephone | 714-839-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC-24563
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License Number State | CA
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