Provider Demographics
NPI:1386727030
Name:MCKEAN, JOHN SCRIBNER JR (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SCRIBNER
Last Name:MCKEAN
Suffix:JR
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 1:3367 GLENDALE BLVD.
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-1825
Mailing Address - Country:US
Mailing Address - Phone:323-661-4325
Mailing Address - Fax:323-668-2206
Practice Address - Street 1:3367 GLENDALE BLVD.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1825
Practice Address - Country:US
Practice Address - Phone:323-661-4325
Practice Address - Fax:323-668-2206
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC24170Medicare UPIN