Provider Demographics
NPI:1790062784
Name:LAGUEUX, MICHAEL THOMAS II (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:THOMAS
Last Name:LAGUEUX
Suffix:II
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 1:10371 CAMINO RUIZ
Mailing Address - Street 2:#82
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-3292
Mailing Address - Country:US
Mailing Address - Phone:408-332-7961
Mailing Address - Fax:
Practice Address - Street 1:10371 CAMINO RUIZ
Practice Address - Street 2:#82
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-3292
Practice Address - Country:US
Practice Address - Phone:408-332-7961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32118111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor