Provider Demographics
NPI:1003392648
Name:ALVORD, SKYLER (DC)
Entity type:Individual
Prefix:DR
First Name:SKYLER
Middle Name:
Last Name:ALVORD
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 1:20 VIA CUENTA NUEVA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92673-7036
Mailing Address - Country:US
Mailing Address - Phone:817-271-1450
Mailing Address - Fax:
Practice Address - Street 1:23032 ALICIA PKWY STE C
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-1600
Practice Address - Country:US
Practice Address - Phone:949-588-9550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-17
Last Update Date:2023-11-02
Deactivation Date:2023-10-27
Deactivation Code:
Reactivation Date:2023-11-02
Provider Licenses
StateLicense IDTaxonomies
CA34698111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor