Provider Demographics
NPI:1134267370
Name:VONJENEF, MERIS (DC)
Entity type:Individual
Prefix:DR
First Name:MERIS
Middle Name:
Last Name:VONJENEF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 SAN DIEGO AVENUE
Mailing Address - Street 2:SUITE B105
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110
Mailing Address - Country:US
Mailing Address - Phone:619-295-9525
Mailing Address - Fax:
Practice Address - Street 1:2251 SAN DIEGO AVE
Practice Address - Street 2:STE B105
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110
Practice Address - Country:US
Practice Address - Phone:619-295-9525
Practice Address - Fax:619-542-0069
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16578111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC16578Medicare ID - Type Unspecified
U16904Medicare UPIN