Provider Demographics
NPI:1831584960
Name:OCONNOR, NICHOLAS BRUCE (DC)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:BRUCE
Last Name:OCONNOR
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 1:4700 VON KARMAN AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2194
Mailing Address - Country:US
Mailing Address - Phone:949-734-4454
Mailing Address - Fax:949-209-2027
Practice Address - Street 1:4700 VON KARMAN AVE STE 1000
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2194
Practice Address - Country:US
Practice Address - Phone:949-734-4454
Practice Address - Fax:949-209-2027
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC33211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor