Organization
ANGELA IACOVINO CHIROPRACTIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA CERICE IACOVINO D.C. (OWNER D.C.)
(949) 642-8193
Entity
Organization
Contact information
Practice address
901 DOVER DR, SUITE 234, NEWPORT BEACH, CA 92660-5538
(949) 642-8193
(949) 642-8195
Mailing address
901 DOVER DR, SUITE 234, NEWPORT BEACH, CA 92660-5538
(949) 642-8193
(949) 642-8195
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC26556
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0265560
BLUE CROSS BLUE SHIELD
CA
01
—
DC26556
COMMERCIAL
CA
05
—
DC26556
—
CA
Enumeration date
11/17/2006
Last updated
10/11/2007
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