Provider Demographics
NPI:1578631974
Name:MCNAMEE, KEVIN PAUL (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:PAUL
Last Name:MCNAMEE
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20121 VENTURA BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2546
Mailing Address - Country:US
Mailing Address - Phone:818-999-4747
Mailing Address - Fax:818-883-9133
Practice Address - Street 1:20121 VENTURA BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2546
Practice Address - Country:US
Practice Address - Phone:818-999-4747
Practice Address - Fax:818-883-9133
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19535111N00000X
CAAC3890171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC19535Medicare ID - Type UnspecifiedMEDICARE IDENTIFIER