Provider Demographics
NPI:1275688533
Name:VAUGHAN, AUDREY MEI (DC)
Entity type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:MEI
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9972 CAMPO RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91977-1611
Mailing Address - Country:US
Mailing Address - Phone:619-469-6327
Mailing Address - Fax:
Practice Address - Street 1:9972 CAMPO RD
Practice Address - Street 2:A
Practice Address - City:SPRING VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91977-1611
Practice Address - Country:US
Practice Address - Phone:619-469-6327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 29956111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor