Provider Demographics
NPI:1932649548
Name:QUON, AUSTIN (DC)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:QUON
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 1:20321 SW BIRCH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1756
Mailing Address - Country:US
Mailing Address - Phone:949-250-0600
Mailing Address - Fax:949-250-1442
Practice Address - Street 1:20321 SW BIRCH ST STE 100
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1756
Practice Address - Country:US
Practice Address - Phone:949-250-0600
Practice Address - Fax:949-250-1442
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33798111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor