Provider Demographics
NPI:1780721274
Name:MCNAMARA, JOHN T (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:MCNAMARA
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 1:2070 BUSINESS CENTER DR STE 198
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1159
Mailing Address - Country:US
Mailing Address - Phone:949-752-6236
Mailing Address - Fax:949-752-6246
Practice Address - Street 1:2070 BUSINESS CENTER DR STE 198
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1159
Practice Address - Country:US
Practice Address - Phone:949-752-6236
Practice Address - Fax:949-752-6246
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26101111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC26101Medicare ID - Type Unspecified