Provider Demographics
NPI:1710323795
Name:STORMS, ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:STORMS
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 1:742 TERRAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-4407
Mailing Address - Country:US
Mailing Address - Phone:562-412-2422
Mailing Address - Fax:
Practice Address - Street 1:220 MAIN ST
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-2588
Practice Address - Country:US
Practice Address - Phone:310-399-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32235111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor