Provider Demographics
NPI:1700817038
Name:BAIR, JOHN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:BAIR
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 1:4811 EUREKA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3368
Mailing Address - Country:US
Mailing Address - Phone:714-579-3900
Mailing Address - Fax:714-579-3901
Practice Address - Street 1:4811 EUREKA AVE STE A
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-3368
Practice Address - Country:US
Practice Address - Phone:714-579-3900
Practice Address - Fax:714-579-3901
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23203111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U99282Medicare UPIN