Provider Demographics
NPI:1831217322
Name:MACDONALD, STEVEN NEIL (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:NEIL
Last Name:MACDONALD
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 1:718 LIGHTHOUSE AVE STE A
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-2562
Mailing Address - Country:US
Mailing Address - Phone:831-375-9528
Mailing Address - Fax:831-375-9529
Practice Address - Street 1:718 LIGHTHOUSE AVE
Practice Address - Street 2:STE A
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-2562
Practice Address - Country:US
Practice Address - Phone:831-375-9528
Practice Address - Fax:831-375-9529
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12752111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADCO127520Medicare ID - Type Unspecified