Provider Demographics
NPI:1013039890
Name:CAMPBELL, BYRON (DC)
Entity Type:Individual
Prefix:
First Name:BYRON
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:KALEI
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2091 SAN JOAQUIN HILLS RD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-6505
Mailing Address - Country:US
Mailing Address - Phone:949-644-0511
Mailing Address - Fax:949-644-5442
Practice Address - Street 1:2091 SAN JOAQUIN HILLS RD
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-6505
Practice Address - Country:US
Practice Address - Phone:949-644-0511
Practice Address - Fax:949-644-5442
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25554111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor