Provider Demographics
NPI:1073857264
Name:JAMES ELLIOTT MYERSON
Entity Type:Organization
Organization Name:JAMES ELLIOTT MYERSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:MYERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-866-3333
Mailing Address - Street 1:PO BOX 76002
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92809-7602
Mailing Address - Country:US
Mailing Address - Phone:562-866-3333
Mailing Address - Fax:
Practice Address - Street 1:10229 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-2601
Practice Address - Country:US
Practice Address - Phone:562-866-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-12
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21617111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty