Provider Demographics
NPI:1649293788
Name:EGERER, JUSTIN MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:MICHAEL
Last Name:EGERER
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 1:1525 N PLACENTIA AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-2334
Mailing Address - Country:US
Mailing Address - Phone:714-996-2356
Mailing Address - Fax:714-996-2414
Practice Address - Street 1:1525 N PLACENTIA AVE
Practice Address - Street 2:SUITE F
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-2334
Practice Address - Country:US
Practice Address - Phone:714-996-2356
Practice Address - Fax:714-996-2414
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor