Healthcare Provider Details

I. General information

NPI: 1326045147
Provider Name (Legal Business Name): JAMES B. CREGG D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9676 CAMPO RD SUITE B
SPRING VALLEY CA
91977-1251
US

IV. Provider business mailing address

9676 CAMPO RD SUITE B
SPRING VALLEY CA
91977-1251
US

V. Phone/Fax

Practice location:
  • Phone: 619-465-9700
  • Fax: 619-465-4712
Mailing address:
  • Phone: 619-465-9700
  • Fax: 619-465-4712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC12147
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: