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General NPI Number Information
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NPI Number | 1740675826
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Entity Type | Organization
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Legal Business Name | DR SIMON KUANGS IDEAL BODY CHIROPRACTIC INC
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Dates
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Enumeration Date | 04/05/2015
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 3283 BERNAL AVE STE 107
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City | PLEASANTON
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State | CA
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Zip | 94566-7157
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Country | US
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Telephone | 925-232-1058
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Fax |
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Provider Business Mailing Address
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Address Line | 3283 BERNAL AVE STE 107
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City | PLEASANTON
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State | CA
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Zip | 94566-7157
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Country | US
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Telephone | 925-232-1058
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SIMON KUANG
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Credential | DC
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Telephone | 415-279-8499
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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 |
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