Individual
DERRICK VINCENT JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
7606 FALLBROOK AVE, 4, WEST HILLS, CA 91304-3610
(818) 457-9948
(818) 887-1577
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
20646
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC20646
CHIROPRACTIC LICENSE
CA
01
—
FA266A
PTAN
CA
Enumeration date
04/26/2011
Last updated
09/16/2011
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