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Organization
THE BREAK OFF
Active
Organization
THE BREAK OFF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLENE CHANDLER (COO)
(562) 370-5523
Entity
Organization
Contact information
Practice address
1735 S DALLAS DR, ANAHEIM, CA 92804-6503
(562) 370-5523
Mailing address
1735 S DALLAS DR, ANAHEIM, CA 92804-6503
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
—
NULL
111NN1001X
Nutrition Chiropractor
—
—
124Q00000X
Dental Hygienist
—
NULL
124Q00000X
Dental Hygienist
—
—
133N00000X
Nutritionist
—
NULL
133N00000X
Nutritionist
—
—
207KA0200X
Allergy Physician
—
NULL
207KA0200X
Allergy Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
NULL
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
Other
Enumeration date
01/27/2025
Last updated
03/10/2025
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