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General NPI Number Information
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NPI Number | 1568827525
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Entity Type | Organization
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Legal Business Name | 5 STAR PRO CENTERS
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Dates
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Enumeration Date | 12/17/2015
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Last Update Date | 12/17/2015
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Provider Practice Location Address
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Address Line | 1041 E YORBA LINDA BLVD STE 210
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City | PLACENTIA
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State | CA
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Zip | 92870-3763
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Country | US
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Telephone | 714-485-9332
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Fax |
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Provider Business Mailing Address
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Address Line | 1041 E YORBA LINDA BLVD STE 210
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City | PLACENTIA
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State | CA
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Zip | 92870-3763
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | NHU DANG
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Credential |
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Telephone | 714-485-9332
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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 |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | CA
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