Provider Demographics
NPI:1174634901
Name:ADAMS, TODD (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2787 BRISTOL ST STE 102
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5956
Mailing Address - Country:US
Mailing Address - Phone:714-556-9188
Mailing Address - Fax:714-957-3825
Practice Address - Street 1:2787 BRISTOL ST STE 102
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5956
Practice Address - Country:US
Practice Address - Phone:714-556-9188
Practice Address - Fax:714-957-3825
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13434111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC13434Medicare ID - Type UnspecifiedCHIROPRACTIC