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General NPI Number Information
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NPI Number | 1275760209
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Entity Type | Organization
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Legal Business Name | REYNOSO-BRUCE CHIROPRACTIC CORP
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Dates
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Enumeration Date | 06/17/2009
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Last Update Date | 03/13/2014
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Provider Practice Location Address
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Address Line | 8873 ADAMS AVE
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-3301
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Country | US
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Telephone | 714-962-8818
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Fax | 714-962-8819
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Provider Business Mailing Address
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Address Line | 8873 ADAMS AVE
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-3301
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Country | US
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Telephone | 714-962-8818
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Fax | 714-962-8819
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT BRUCE REYNOSO
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Credential | DC
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Telephone | 714-962-8818
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT34304
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC11436
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC11274
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC23961
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License Number State | CA
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