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General NPI Number Information
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NPI Number | 1871981720
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Entity Type | Individual
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Provider Name | DAVID JUSTIN VALLE D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/30/2014
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Last Update Date | 12/27/2017
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Provider Practice Location Address
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Address Line | 12721 NEWPORT AVE STE 2
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City | TUSTIN
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State | CA
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Zip | 92780-8031
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Country | US
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Telephone | 949-587-9990
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Fax |
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Provider Business Mailing Address
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Address Line | 4921 KAREN ANN LN
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City | IRVINE
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State | CA
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Zip | 92604-2441
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Country | US
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Telephone | 909-557-5384
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 33142
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License Number State | CA
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