Healthcare Provider Details

I. General information

NPI: 1457683716
Provider Name (Legal Business Name): JOHN J. CAAMANO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 02/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 W TEMPLE ST SUITE 4607
LOS ANGELES CA
90026-5421
US

IV. Provider business mailing address

PO BOX 55458
SHERMAN OAKS CA
91413-0458
US

V. Phone/Fax

Practice location:
  • Phone: 213-413-8418
  • Fax: 213-413-8437
Mailing address:
  • Phone: 818-461-0790
  • Fax: 818-461-1879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC22933
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: