Provider Demographics
NPI:1841630886
Name:MCCABE, JOHN C (LAC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:MCCABE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5003 E MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-1943
Mailing Address - Country:US
Mailing Address - Phone:858-751-4624
Mailing Address - Fax:
Practice Address - Street 1:9820 WILLOW CREEK RD
Practice Address - Street 2:SUITE 485
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1112
Practice Address - Country:US
Practice Address - Phone:858-689-1335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-03
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15458171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist