Provider Demographics
NPI:1427148816
Name:COMEAU, CHERYL ANN (DC)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANN
Last Name:COMEAU
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 1:30111 NIGUEL RD STE E
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2260
Mailing Address - Country:US
Mailing Address - Phone:949-495-4455
Mailing Address - Fax:
Practice Address - Street 1:30111 NIGUEL RD STE E
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-2260
Practice Address - Country:US
Practice Address - Phone:949-495-4455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13756111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU30474Medicare ID - Type Unspecified