Provider Demographics
NPI:1669519427
Name:FIROZZ, DAVID (AC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:FIROZZ
Suffix:
Gender:M
Credentials:AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18582 BEACH BLVD
Mailing Address - Street 2:SUITE 23A
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648
Mailing Address - Country:US
Mailing Address - Phone:714-964-4448
Mailing Address - Fax:714-963-3780
Practice Address - Street 1:18582 BEACH BLVD
Practice Address - Street 2:SUITE 23A
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2000
Practice Address - Country:US
Practice Address - Phone:949-752-1111
Practice Address - Fax:949-752-1133
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2208171100000X
CAPT5610208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC2208OtherACUPUNTURE LICENSE
CAAC2208OtherACUPUNTURE LICENSE