Provider Demographics
NPI:1801916424
Name:CHEELEY, JAMES EVERETT (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EVERETT
Last Name:CHEELEY
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 1:900 E WASHINGTON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-8182
Mailing Address - Country:US
Mailing Address - Phone:909-533-4591
Mailing Address - Fax:909-533-4597
Practice Address - Street 1:900 E WASHINGTON ST STE 300
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-8182
Practice Address - Country:US
Practice Address - Phone:909-533-4591
Practice Address - Fax:909-533-4597
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2019-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13290111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0132900 006Medicaid
CAZZZ28803ZMedicare ID - Type Unspecified
CAT04957Medicare UPIN