Provider Demographics
NPI:1982648952
Name:MCGHEE, MICHAEL TERRENCE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TERRENCE
Last Name:MCGHEE
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 1:225 WASHINGTON ST
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-5975
Mailing Address - Country:US
Mailing Address - Phone:408-274-7990
Mailing Address - Fax:408-247-7990
Practice Address - Street 1:225 WASHINGTON ST
Practice Address - Street 2:SUITE B-1
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-5975
Practice Address - Country:US
Practice Address - Phone:408-274-7990
Practice Address - Fax:408-247-7990
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22767111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician