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General NPI Number Information
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NPI Number | 1750614616
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Entity Type | Individual
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Provider Name | ARTHUR AZCONA D.C
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Gender | Male
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Dates
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Enumeration Date | 09/10/2009
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Last Update Date | 10/09/2009
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Provider Practice Location Address
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Address Line | 2675 IRVINE AVE SUIT E
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City | COSTA MESA
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State | CA
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Zip | 92627-4653
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Country | US
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Telephone | 714-910-1478
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Fax | 714-849-6584
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Provider Business Mailing Address
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Address Line | PO BOX 6612
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92615-6612
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Country | US
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Telephone | 714-910-1478
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Fax | 714-849-6584
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 31385
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License Number State | CA
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