Provider Demographics
NPI:1982820411
Name:GOMEZ, JOHN ME (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ME
Last Name:GOMEZ
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 1:625 CRESTON RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-2713
Mailing Address - Country:US
Mailing Address - Phone:805-239-0177
Mailing Address - Fax:805-239-0177
Practice Address - Street 1:625 CRESTON RD
Practice Address - Street 2:SUITE A
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-2713
Practice Address - Country:US
Practice Address - Phone:805-239-0177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor