Individual provider · NPI-1

Dr. Samuel Roy Cornell, DC, ATC

Chiropractor · Mission Viejo, CA

NPI number1255880308
StatusActive
Last updated in NPPESFeb 19, 2022

Details

NPI
1255880308
Entity type
Individual (NPI-1)
Name
Dr. Samuel Roy Cornell
Credential
DC, ATC
Sex
Male
Sole proprietor
Yes
Enumeration date
Sep 30, 2016
Certification date
Feb 19, 2022
Last updated
Feb 19, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X ChiropractorDC36279CAYes

Practice location

24002 Via Fabricante Ste 501
Mission Viejo, CA 92691-3934

Phone 949-454-8811

Mailing address

39 Feldspar Way
Rancho Santa Margarita, CA 92688-3518

Phone 949-338-3880

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