Dr. Jean Derek Potvin
Chiropractic Sports Physician
24470 Del Prado
Dana Point
, California 92629-2739
Dr. Jean Derek Potvin
Chiropractic Sports Physician
24470 Del Prado
Dana Point
, California 92629-2739
(949) 488-0348
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About
Features
Specialties
- Chiropractic Sports Physician
Languages spoken
- English
Location
First Address
- Dr. Jean Derek Potvin
- 24470 Del Prado
- Dana Point, CA
- Zip : 92629-2739
- Phone : (949) 488-0348
Second Address
- Dr. Jean Derek Potvin
- 24470 Del Prado
- Dana Point, CA
- Zip : 92629-2739
- Phone : (949) 488-0348
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NS0005X | Chiropractic Sports Physician | DC-27513 | CA |
National Provider Identifier
| NPI | 1124194345 |
|---|---|
| Provider Name | Dr. Jean Derek Potvin |
| First Address | Dana Point, CA 92629-2739 |
| Second Address | Dana Point, CA 92629-2739 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/11/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 487877 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.