Provider Demographics
NPI:1427388396
Name:DORRIS, JEREMY SEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:SEAN
Last Name:DORRIS
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 1:10330 FRIARS RD
Mailing Address - Street 2:STE 111
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-2300
Mailing Address - Country:US
Mailing Address - Phone:619-405-4740
Mailing Address - Fax:
Practice Address - Street 1:10330 FRIARS RD STE 111
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-2300
Practice Address - Country:US
Practice Address - Phone:619-281-7800
Practice Address - Fax:619-542-1792
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31471111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician