MEDICARE: CHLOE FAYE SANDOVAL DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC36923	CA

General Provider Information

NPI Number	:	1255191326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHLOE FAYE SANDOVAL DC

Provider Business Mailing Address
First Line	:	1015 E CHAPMAN AVE
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92866-2110
Country	:	US
Telephone Number	:	657-650-8983
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 E CHAPMAN AVE
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92866-2110
Country	:	US
Telephone Number	:	657-650-8983
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2024
Last Update Date	:	03/19/2024

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Directions to “ CHLOE FAYE SANDOVAL DC” Practice Location

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