Provider Demographics
NPI:1881212835
Name:DE BOARD, WILLIAM ERIC (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ERIC
Last Name:DE BOARD
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 1:601 E YORBA LINDA BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3006
Mailing Address - Country:US
Mailing Address - Phone:714-528-7500
Mailing Address - Fax:
Practice Address - Street 1:601 E YORBA LINDA BLVD STE 4
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3006
Practice Address - Country:US
Practice Address - Phone:714-528-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34864111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor