Provider Demographics
NPI:1376760918
Name:LAMOG, JAMES ANTHONY (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANTHONY
Last Name:LAMOG
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 1:23161 VENTURA BLVD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1105
Mailing Address - Country:US
Mailing Address - Phone:818-608-3529
Mailing Address - Fax:
Practice Address - Street 1:23161 VENTURA BLVD
Practice Address - Street 2:SUITE 209
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1105
Practice Address - Country:US
Practice Address - Phone:818-608-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20673111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC20673Medicare ID - Type Unspecified