Provider Demographics
NPI:1518073766
Name:PROETZ, JAMES F (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:PROETZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:834 E 4TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-7208
Mailing Address - Country:US
Mailing Address - Phone:562-590-9932
Mailing Address - Fax:562-590-9932
Practice Address - Street 1:834 E 4TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-7212
Practice Address - Country:US
Practice Address - Phone:562-590-9932
Practice Address - Fax:562-590-9932
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC15018Medicare ID - Type Unspecified