Provider Demographics
NPI:1821145244
Name:HEDGECOCK, JAMES JEFFREY (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JEFFREY
Last Name:HEDGECOCK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:J.
Other - Middle Name:JEFF
Other - Last Name:HEDGECOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:18102 SKY PARK CIR STE D
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6531
Mailing Address - Country:US
Mailing Address - Phone:949-756-2277
Mailing Address - Fax:949-333-2225
Practice Address - Street 1:18102 SKY PARK CIR STE D
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6531
Practice Address - Country:US
Practice Address - Phone:949-756-2277
Practice Address - Fax:949-333-2225
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23273111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC23273OtherSTATE LICENSE NUMBER
CA330682501OtherTAX ID
CADC23273OtherSTATE LICENSE NUMBER