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General NPI Number Information
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NPI Number | 1770911810
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Entity Type | Organization
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Legal Business Name | ORANGE COUNTY WELLNESS PHYSICIANS MEDICAL CENTER INC.
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 14120 BEACH BLVD STE 214
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City | WESTMINSTER
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State | CA
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Zip | 92683-4454
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Country | US
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Telephone | 866-303-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 14120 BEACH BLVD STE 214
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City | WESTMINSTER
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State | CA
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Zip | 92683-4454
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Country | US
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Telephone | 866-303-9355
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW GRIFFITH
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Credential | DC
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Telephone | 866-303-9533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 31329
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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 | 14140
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 27729
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | G59013
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License Number State | CA
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