Provider Demographics
NPI:1275601304
Name:VANDAL, JAMES B (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:VANDAL
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 1:4725 HUTSON WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-3543
Mailing Address - Country:US
Mailing Address - Phone:916-714-6447
Mailing Address - Fax:916-972-1615
Practice Address - Street 1:2400 MARCONI AVE STE D
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-4858
Practice Address - Country:US
Practice Address - Phone:916-972-1100
Practice Address - Fax:916-972-1615
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0288670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor