Provider Demographics
NPI:1376604462
Name:COX, MAYDA E (DC)
Entity Type:Individual
Prefix:
First Name:MAYDA
Middle Name:E
Last Name:COX
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 ORANGE AVE
Mailing Address - Street 2:STE B
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-3130
Mailing Address - Country:US
Mailing Address - Phone:949-260-8459
Mailing Address - Fax:
Practice Address - Street 1:4630 CAMPUS DR
Practice Address - Street 2:SUITE 105
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1822
Practice Address - Country:US
Practice Address - Phone:949-260-8459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23777111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC23777OtherLICENSE
CAWDC23777AMedicare ID - Type UnspecifiedMEDICARE