Provider Demographics
NPI:1487886792
Name:JAMES, MICHAEL JUSTIN (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JUSTIN
Last Name:JAMES
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 1:30555 TRABUCO CANYON ROAD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TRABUCO CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:92679-3003
Mailing Address - Country:US
Mailing Address - Phone:949-589-2992
Mailing Address - Fax:949-589-2992
Practice Address - Street 1:30555 TRABUCO CANYON ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:TRABUCO CANYON
Practice Address - State:CA
Practice Address - Zip Code:92679-3003
Practice Address - Country:US
Practice Address - Phone:949-589-2992
Practice Address - Fax:949-589-2992
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor