Provider Demographics
NPI:1871658146
Name:KEVIN P MCNAMEE DC A PROFESSIONAL CHIROPRACTIC CORP
Entity Type:Organization
Organization Name:KEVIN P MCNAMEE DC A PROFESSIONAL CHIROPRACTIC CORP
Other - Org Name:CALIFORNIA HEALTH INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MCNAMEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:818-999-4747
Mailing Address - Street 1:20121 VENTURA BLVD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2546
Mailing Address - Country:US
Mailing Address - Phone:818-999-4747
Mailing Address - Fax:
Practice Address - Street 1:20121 VENTURA BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2546
Practice Address - Country:US
Practice Address - Phone:818-999-4747
Practice Address - Fax:818-883-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19535111N00000X
CAAC3890171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC19535Medicare ID - Type UnspecifiedMEDICARE