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General NPI Number Information
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NPI Number | 1528587003
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Entity Type | Individual
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Provider Name | TRAVIS COMEAU DC, PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 12/16/2020
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Provider Practice Location Address
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Address Line | 14120 BEACH BLVD STE 214
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City | WESTMINSTER
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State | CA
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Zip | 92683-4454
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Country | US
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Telephone | 866-303-9355
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Fax | 610-644-3162
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Provider Business Mailing Address
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Address Line | 4 INDUSTRIAL BLVD STE 200
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City | PAOLI
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State | PA
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Zip | 19301-1605
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Country | US
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Telephone | 610-644-3166
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Fax | 610-644-3162
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC011300
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 34965
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License Number State | CA
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