Oc Back & Body Doctors

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC26277 Issued in CA

Legal business name

OC BACK & BODY DOCTORS

Practice address

17264 Red Hill Ave
Irvine, CA 92614-5628

Phone

(949) 724-0011

Fax

(949) 724-0012

NPI assigned

Aug 13, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Desiree Deanne Edlund, D.C.

Title

Clinic Director

Phone

(949) 724-0011

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217808000000",
    "number": "1194737270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17264 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145628",
            "telephone_number": "949-724-0011",
            "fax_number": "949-724-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17264 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145628",
            "telephone_number": "949-724-0011",
            "fax_number": "949-724-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OC BACK & BODY DOCTORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2008-08-04",
        "status": "A",
        "authorized_official_last_name": "EDLUND",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_middle_name": "DEANNE",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "949-724-0011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC26277",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "PT28504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Irvine, CA
• Providers in Irvine, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.