MEDICARE: DR. TORI RECCORD 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	34443	CA

General Provider Information

NPI Number	:	1518424589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TORI RECCORD DC

Provider Business Mailing Address
First Line	:	5324 E SHOSHONE AVE
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92867-3266
Country	:	US
Telephone Number	:	805-268-1478
Fax Number	:

Provider Business Practice Location Address
First Line	:	14340 BOLSA CHICA RD STE G
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4868
Country	:	US
Telephone Number	:	714-709-8030
Fax Number	:

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

Provider Enumeration Date	:	02/26/2019
Last Update Date	:	01/14/2020

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