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General NPI Number Information
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NPI Number | 1467898494
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Entity Type | Organization
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Legal Business Name | DERRICK V. JOSEPH CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 6928 OWENSMOUTH AVE
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City | CANOGA PARK
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State | CA
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Zip | 91303-2095
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Country | US
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Telephone | 818-712-9181
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Fax |
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Provider Business Mailing Address
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Address Line | 15550 ROCKFIELD BLVD B220
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City | IRVINE
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State | CA
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Zip | 92618-2720
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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 | OWNER / PROVIDER
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Name | DERRICK V JOSEPH
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Credential | D.C.
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Telephone | 818-712-9181
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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 | DC20646
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License Number State | CA
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