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Organization
PORATH CHIROPRACTIC CORPORATION
Active
Organization
PORATH CHIROPRACTIC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM T PORATH D.C. (OWNER / PROVIDER)
(714) 313-4212
Entity
Organization
Contact information
Practice address
1748 W KATELLA AVE, 107, ORANGE, CA 92867-3437
(714) 313-4212
(714) 464-5365
Mailing address
15550 ROCKFIELD BLVD, B220, IRVINE, CA 92618-2720
(949) 598-9999
(949) 598-9990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC26124
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC26124
D.C. LICENSE
CA
01
—
INDIVIDUAL NPI
1659696748
CA
01
—
ZZZ03106Z
BLUE SHIELD
CA
Enumeration date
03/31/2010
Last updated
12/01/2014
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