Provider Demographics
NPI:1720068331
Name:HOUSEMAN, JOSEPH P (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:HOUSEMAN
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 1:2061 W AVENUE K
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-5234
Mailing Address - Country:US
Mailing Address - Phone:661-945-9699
Mailing Address - Fax:661-945-4259
Practice Address - Street 1:2061 W AVENUE K
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-5234
Practice Address - Country:US
Practice Address - Phone:661-945-9699
Practice Address - Fax:661-945-4259
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17712111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA54220DC0177120OtherBLUE SHIELD PROVIDER ID
CAT06542Medicare UPIN
CADC17712Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID