Provider Demographics
NPI:1225042880
Name:DE LEMOS, JOHN B (D C)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:DE LEMOS
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24394 MIRA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-6036
Mailing Address - Country:US
Mailing Address - Phone:661-993-3839
Mailing Address - Fax:661-259-1870
Practice Address - Street 1:21704 GOLDEN TRIANGLE RD
Practice Address - Street 2:STE 104
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-5833
Practice Address - Country:US
Practice Address - Phone:661-222-9021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24329111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC24329Medicare ID - Type Unspecified
CAU66656Medicare UPIN