Provider Demographics
NPI:1689737447
Name:DOOMAN, EDMOND (DC)
Entity Type:Individual
Prefix:
First Name:EDMOND
Middle Name:
Last Name:DOOMAN
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 1:4087 MISSION OAKS BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5156
Mailing Address - Country:US
Mailing Address - Phone:805-484-1077
Mailing Address - Fax:805-484-1079
Practice Address - Street 1:4087 MISSION OAKS BLVD STE B
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5156
Practice Address - Country:US
Practice Address - Phone:805-419-4234
Practice Address - Fax:805-484-1079
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor