Provider Demographics
NPI:1922174135
Name:HUNTINGTON HEALTH CENTER
Entity Type:Organization
Organization Name:HUNTINGTON HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MALONEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-962-8200
Mailing Address - Street 1:9935 YORKTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-2842
Mailing Address - Country:US
Mailing Address - Phone:714-962-8200
Mailing Address - Fax:714-964-2233
Practice Address - Street 1:9935 YORKTOWN AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-2842
Practice Address - Country:US
Practice Address - Phone:714-962-8200
Practice Address - Fax:714-964-2233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21417111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC21417Medicare PIN