Provider Demographics
NPI:1295151553
Name:ENGELMAN, JOHN ARTHUR
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ARTHUR
Last Name:ENGELMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10908 EL CID AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5315
Mailing Address - Country:US
Mailing Address - Phone:714-225-5021
Mailing Address - Fax:562-424-7344
Practice Address - Street 1:2777 PACIFIC AVE
Practice Address - Street 2:B
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2625
Practice Address - Country:US
Practice Address - Phone:562-427-6366
Practice Address - Fax:562-424-7344
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor