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General NPI Number Information
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NPI Number | 1033359146
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Entity Type | Individual
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Provider Name | PATRICK L DORMAN D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 10/09/2015
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Provider Practice Location Address
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Address Line | 3330 4TH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92103-5704
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Country | US
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Telephone | 619-297-4091
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Fax | 619-297-1227
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Provider Business Mailing Address
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Address Line | 15520 ROCKFIELD BLVD A200
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City | IRVINE
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State | CA
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Zip | 92618-6705
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Country | US
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Telephone | 949-598-9999
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Fax | 949-598-9990
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DC19434
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License Number State | CA
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