Individual
DR. ANGELA CERICE IACOVINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
901 DOVER DR, SUITE 234, NEWPORT BEACH, CA 92660-5538
(949) 642-8193
(949) 325-0817
Mailing address
901 DOVER DRIVE,, SUITE 234, NEWPORT BEACH, CA 92660-5515
(949) 642-8193
(949) 325-0817
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC26556
CA
111NN1001X
Nutrition Chiropractor
DC26556
CA
111NS0005X
Sports Physician Chiropractor
DC26556
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0265560
BLUE CROSS/SHIELD
CA
01
—
DC26556
COMMERCIAL
CA
05
—
DC26556
—
CA
Enumeration date
09/05/2006
Last updated
03/17/2016
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