Provider Demographics
NPI:1992955215
Name:DOCTOR O INC
Entity type:Organization
Organization Name:DOCTOR O INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:T
Authorized Official - Last Name:OGINO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-813-2196
Mailing Address - Street 1:125 BAKER ST E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4509
Mailing Address - Country:US
Mailing Address - Phone:949-813-2196
Mailing Address - Fax:
Practice Address - Street 1:125 BAKER ST E
Practice Address - Street 2:SUITE 100
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4509
Practice Address - Country:US
Practice Address - Phone:949-813-2196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23343111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty