Provider Demographics
NPI:1992491674
Name:MAIN PLACE CHIROPRACTIC
Entity type:Organization
Organization Name:MAIN PLACE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:DOERING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:714-542-3662
Mailing Address - Street 1:1111 W TOWN AND COUNTRY RD STE 6
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4635
Mailing Address - Country:US
Mailing Address - Phone:714-542-3662
Mailing Address - Fax:
Practice Address - Street 1:1111 W TOWN AND COUNTRY RD STE 6
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4635
Practice Address - Country:US
Practice Address - Phone:714-835-2225
Practice Address - Fax:714-569-0463
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAIN PLACE CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-14
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service