Provider Demographics
NPI:1629063037
Name:NEARY, JAMES RICHARD (DC QME)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RICHARD
Last Name:NEARY
Suffix:
Gender:M
Credentials:DC QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 BEECH CT
Mailing Address - Street 2:
Mailing Address - City:BUELLTON
Mailing Address - State:CA
Mailing Address - Zip Code:93427-6805
Mailing Address - Country:US
Mailing Address - Phone:805-692-9749
Mailing Address - Fax:805-692-1899
Practice Address - Street 1:5290 OVERPASS RD
Practice Address - Street 2:STE 101
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2042
Practice Address - Country:US
Practice Address - Phone:805-692-9749
Practice Address - Fax:805-686-2074
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19546111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U43407Medicare UPIN
DC19546Medicare ID - Type Unspecified