Provider Demographics
NPI:1326365644
Name:HANDY CHIROPRACTIC, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:HANDY CHIROPRACTIC, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:HANDY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-252-1228
Mailing Address - Street 1:4100 CAMPUS DR STE 130
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1930
Mailing Address - Country:US
Mailing Address - Phone:949-252-1228
Mailing Address - Fax:
Practice Address - Street 1:4100 CAMPUS DR STE 130
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1930
Practice Address - Country:US
Practice Address - Phone:949-252-1228
Practice Address - Fax:949-252-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-26
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1689694663OtherSOLE PROPRIETERSHIP NPI NUMBER FOR OUR DOCTOR