Provider Demographics
NPI:1447350376
Name:CLEAVER, MICHAEL JEFFERY (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JEFFERY
Last Name:CLEAVER
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 1:21580 STEVENS CREEK BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-1244
Mailing Address - Country:US
Mailing Address - Phone:408-253-9414
Mailing Address - Fax:
Practice Address - Street 1:21580 STEVENS CREEK BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-1244
Practice Address - Country:US
Practice Address - Phone:408-253-9414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0289360Medicare ID - Type Unspecified