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General NPI Number Information
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NPI Number | 1922305085
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Entity Type | Organization
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Legal Business Name | LAVEN CHIROPRACTIC INC
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 601 E YORBA LINDA BLVD SUITE 4
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City | PLACENTIA
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State | CA
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Zip | 92870-3006
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Country | US
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Telephone | 714-528-7500
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Fax | 714-528-8815
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Provider Business Mailing Address
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Address Line | 601 E YORBA LINDA BLVD SUITE 4
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City | PLACENTIA
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State | CA
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Zip | 92870-3006
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Country | US
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Telephone | 714-528-7500
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Fax | 714-528-8815
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Authorized Official
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Title or Position | OWNER
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Name | DR. J GREGORY LAVEN
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Credential | DC
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Telephone | 714-528-7500
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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 | DC20676
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License Number State | CA
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