Provider Demographics
NPI:1679546345
Name:ACIERNO, ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:ACIERNO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25081 REFLEJO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-2722
Mailing Address - Country:US
Mailing Address - Phone:949-874-8036
Mailing Address - Fax:
Practice Address - Street 1:250 EL CAMINO REAL
Practice Address - Street 2:SUITE 104
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3655
Practice Address - Country:US
Practice Address - Phone:714-835-2881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 13727111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA13727OtherUSED WITH ALL OTHER PTOVI
CADC0137270OtherBLUE SHIELD OF CA
CADC0137271OtherBLUE SHIELD OF CA
CADC0137270Medicaid
CA0667867OtherCIGNA HEALTHCARE
CADC013727OtherBLUE CROSS OF CA
CADC0137271OtherBLUE SHIELD OF CA