Provider Demographics
NPI:1205991213
Name:MAHER, JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:MAHER
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 1:30523 TERRACE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:CA
Mailing Address - Zip Code:92082-5256
Mailing Address - Country:US
Mailing Address - Phone:858-342-1614
Mailing Address - Fax:760-751-3559
Practice Address - Street 1:28714 VALLEY CENTER RD
Practice Address - Street 2:SUITE I
Practice Address - City:VALLEY CENTER
Practice Address - State:CA
Practice Address - Zip Code:92082-6554
Practice Address - Country:US
Practice Address - Phone:760-500-6253
Practice Address - Fax:760-751-3559
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12754111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition