Provider Demographics
NPI:1740675826
Name:DR SIMON KUANGS IDEAL BODY CHIROPRACTIC INC
Entity type:Organization
Organization Name:DR SIMON KUANGS IDEAL BODY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:
Authorized Official - Last Name:KUANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:415-279-8499
Mailing Address - Street 1:3283 BERNAL AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7157
Mailing Address - Country:US
Mailing Address - Phone:925-232-1058
Mailing Address - Fax:
Practice Address - Street 1:3283 BERNAL AVE STE 107
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7157
Practice Address - Country:US
Practice Address - Phone:925-232-1058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-05
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty