Provider Demographics
NPI:1922189364
Name:REED, MICHAEL PATRICK (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PATRICK
Last Name:REED
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 1:16200 E AMBER VALLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604
Mailing Address - Country:US
Mailing Address - Phone:562-947-8755
Mailing Address - Fax:562-902-3332
Practice Address - Street 1:16200 E AMBER VALLEY DRIVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604
Practice Address - Country:US
Practice Address - Phone:562-947-8755
Practice Address - Fax:562-902-3332
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T05483Medicare UPIN
CAWDC14732BMedicare ID - Type Unspecified