Provider Demographics
NPI:1750614616
Name:AZCONA, ARTHUR (DC)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:
Last Name:AZCONA
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:PO BOX 6612
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92615-6612
Mailing Address - Country:US
Mailing Address - Phone:714-910-1478
Mailing Address - Fax:714-849-6584
Practice Address - Street 1:2675 IRVINE AVE
Practice Address - Street 2:SUIT E
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-4653
Practice Address - Country:US
Practice Address - Phone:714-910-1478
Practice Address - Fax:714-849-6584
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-10
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31385111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation