Provider Demographics
NPI:1780759001
Name:REAMES, DARRYL ANTHONY (DC)
Entity type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:ANTHONY
Last Name:REAMES
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 1:25381 ALICIA PKWY J
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-4957
Mailing Address - Country:US
Mailing Address - Phone:949-951-5661
Mailing Address - Fax:949-951-3126
Practice Address - Street 1:25381 ALICIA PKWY
Practice Address - Street 2:STE J
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-4957
Practice Address - Country:US
Practice Address - Phone:949-951-5661
Practice Address - Fax:949-951-3126
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12803111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T04910Medicare UPIN
CADC12803Medicare ID - Type Unspecified