Provider Demographics
NPI:1396823852
Name:JONES, JEFFREY MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:JONES
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 1:7388 CARNELIAN ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-1160
Mailing Address - Country:US
Mailing Address - Phone:909-980-1771
Mailing Address - Fax:909-944-9502
Practice Address - Street 1:7388 CARNELIAN ST
Practice Address - Street 2:SUITE D
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-1160
Practice Address - Country:US
Practice Address - Phone:909-980-1771
Practice Address - Fax:909-944-9502
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14098111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0140980Medicare ID - Type UnspecifiedCHIROPRACTOR