Provider Demographics
NPI:1326008897
Name:PEDREIRO, JAMES M (DC, QME)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:PEDREIRO
Suffix:
Gender:M
Credentials:DC, QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 E CAMPBELL AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2341
Mailing Address - Country:US
Mailing Address - Phone:408-371-6003
Mailing Address - Fax:408-371-6009
Practice Address - Street 1:880 E CAMPBELL AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2341
Practice Address - Country:US
Practice Address - Phone:408-371-6003
Practice Address - Fax:408-371-6009
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-25608111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU87149Medicare UPIN
CADC-0256080Medicare ID - Type UnspecifiedCHIROPRACTOR PROVIDER ID