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Individual

CHARLES FAGENHOLZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
3151 AIRWAY AVE, U-3, COSTA MESA, CA 92626-4607
(714) 754-8008
Mailing address
21264 BEACH BLVD, #203, HUNTINGTON BEACH, CA 92648-5482

Taxonomy

Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
Primary
33312
CA

Other

Enumeration date
05/09/2016
Last updated
05/09/2016
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