Provider Demographics
NPI:1245969609
Name:QUALIFIED MED EVAL
Entity type:Organization
Organization Name:QUALIFIED MED EVAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-996-0099
Mailing Address - Street 1:3435 E THOUSAND OAKS BLVD UNIT 3157
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91359-7908
Mailing Address - Country:US
Mailing Address - Phone:916-996-0099
Mailing Address - Fax:
Practice Address - Street 1:301 E COLORADO BLVD STE 711
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1911
Practice Address - Country:US
Practice Address - Phone:916-996-0099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty