Provider Demographics
NPI:1841360245
Name:ADAMO, VINCENT G (DC)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:G
Last Name:ADAMO
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 1:15550 ROCKFIELD BLVD
Mailing Address - Street 2:B220
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2720
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:820 JAMACHA RD # 103
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-3205
Practice Address - Country:US
Practice Address - Phone:619-579-1068
Practice Address - Fax:619-579-5014
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21212111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18962OtherINDIVIDUAL PTAN
CADC21212OtherCHIROPRACTIC LICENSE
CA1700073970OtherGROUP NPI