Provider Demographics
NPI:1538193578
Name:O.C. CHIROPRACTIC SPINE & DISC CENTER
Entity type:Organization
Organization Name:O.C. CHIROPRACTIC SPINE & DISC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANG
Authorized Official - Middle Name:JOON
Authorized Official - Last Name:RHEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-782-7855
Mailing Address - Street 1:1530 S POMONA AVE
Mailing Address - Street 2:UNIT B29
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-3462
Mailing Address - Country:US
Mailing Address - Phone:714-926-4118
Mailing Address - Fax:
Practice Address - Street 1:421 N BROOKHURST ST
Practice Address - Street 2:SUITE 124
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5637
Practice Address - Country:US
Practice Address - Phone:714-782-7855
Practice Address - Fax:714-783-7909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29652174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty