Provider Demographics
NPI:1558303313
Name:HUNTER, CLARENCE ALEXANDER III (DC)
Entity Type:Individual
Prefix:DR
First Name:CLARENCE
Middle Name:ALEXANDER
Last Name:HUNTER
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:16702 VALLEY VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-5824
Mailing Address - Country:US
Mailing Address - Phone:714-367-5360
Mailing Address - Fax:714-635-5428
Practice Address - Street 1:5345 IRWINDALE AVE
Practice Address - Street 2:
Practice Address - City:IRWINDALE
Practice Address - State:CA
Practice Address - Zip Code:91706-2025
Practice Address - Country:US
Practice Address - Phone:626-960-5361
Practice Address - Fax:626-337-0833
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC28679AMedicare PIN
CAWDC28679BMedicare PIN
CAV09833Medicare UPIN