Organization
CHIROPRACTIC CARE OF VICTOR VALLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE G BROUGHTON D.C. (OWNER DR OF CHIROPRACTIC)
(760) 946-4619
Entity
Organization
Contact information
Practice address
18484 US HIGHWAY 18, 280B, APPLE VALLEY, CA 92307-2375
(760) 946-4619
(760) 946-2360
Mailing address
95 ARGONAUT, 280, ALISO VIEJO, CA 92656-4133
(949) 598-9999
(949) 598-9990
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC14559
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0145590
BLUE SHIELD
CA
Enumeration date
05/10/2007
Last updated
08/22/2020
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