Provider Demographics
NPI:1548591944
Name:DAMIAN, NEAL M (DC)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:M
Last Name:DAMIAN
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 1:23672 BIRTCHER DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-1769
Mailing Address - Country:US
Mailing Address - Phone:949-294-2939
Mailing Address - Fax:949-394-9953
Practice Address - Street 1:23672 BIRTCHER DR
Practice Address - Street 2:SUITE B
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-1769
Practice Address - Country:US
Practice Address - Phone:949-394-9953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 31484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor