Provider Demographics
NPI:1205951191
Name:TREANOR, ROBERT M (DC, LAC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:TREANOR
Suffix:
Gender:M
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 S HARWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-1629
Mailing Address - Country:US
Mailing Address - Phone:949-275-8306
Mailing Address - Fax:949-275-8306
Practice Address - Street 1:168 S HARWOOD ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-1629
Practice Address - Country:US
Practice Address - Phone:949-275-8306
Practice Address - Fax:949-275-8306
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 2241171100000X
CADC# 14791111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist