Provider Demographics
NPI:1114101953
Name:DAVID AHRENS
Entity Type:Organization
Organization Name:DAVID AHRENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DAVID AHRENS/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:AHRENS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-240-1334
Mailing Address - Street 1:629 CAMINO DE LOS MARES
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-2829
Mailing Address - Country:US
Mailing Address - Phone:714-240-1334
Mailing Address - Fax:949-240-4434
Practice Address - Street 1:629 CAMINO DE LOS MARES
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-2829
Practice Address - Country:US
Practice Address - Phone:714-240-1334
Practice Address - Fax:949-240-4434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC15856Medicare PIN