Provider Demographics
NPI:1639187644
Name:ROSENFELD, IRIS LYNN (DC)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:LYNN
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25255 CABOT ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-380-7215
Mailing Address - Fax:949-380-7649
Practice Address - Street 1:25255 CABOT ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-380-7215
Practice Address - Fax:949-380-7649
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
I18228Medicare UPIN
CADC16040Medicare ID - Type Unspecified