Provider Demographics
NPI:1356395669
Name:HARPER, JOHN LEE (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEE
Last Name:HARPER
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 1:1816 OCEANSIDE BLVD
Mailing Address - Street 2:#B
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-3450
Mailing Address - Country:US
Mailing Address - Phone:760-722-3202
Mailing Address - Fax:760-722-4278
Practice Address - Street 1:1816 OCEANSIDE BLVD
Practice Address - Street 2:#B
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3450
Practice Address - Country:US
Practice Address - Phone:760-722-3202
Practice Address - Fax:760-722-4278
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17175111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC17175Medicare ID - Type Unspecified
CAT18495Medicare UPIN