Provider Demographics
NPI:1528104221
Name:HAMMOND, CHRIS DOUGLAS (DC)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:DOUGLAS
Last Name:HAMMOND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16168 BEACH BLVD STE 135
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3879
Mailing Address - Country:US
Mailing Address - Phone:714-841-8974
Mailing Address - Fax:714-841-2564
Practice Address - Street 1:16168 BEACH BLVD STE 135
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3879
Practice Address - Country:US
Practice Address - Phone:714-841-8974
Practice Address - Fax:714-841-2564
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23267111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA23267Medicare UPIN