Caleb Lee McNeal, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

12156201-1206 Issued in UT

Practice address

Dewart BHC Bridgeport, McMwtc
BLDG 3005 S.R 108
Bridgeport, CA 93517-9802

Phone

(760) 932-1616

NPI assigned

Oct 5, 2017

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1811407778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEWART BHC BRIDGEPORT, MCMWTC",
            "address_2": "BLDG 3005 S.R 108",
            "city": "BRIDGEPORT",
            "state": "CA",
            "postal_code": "935179802",
            "telephone_number": "607-932-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEWART BHC BRIDGEPORT, MCMWTC",
            "address_2": "BLDG 3005 S.R 108",
            "city": "BRIDGEPORT",
            "state": "CA",
            "postal_code": "935179802",
            "telephone_number": "760-932-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNEAL",
        "first_name": "CALEB",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-05",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12156201-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Bridgeport, CA
• Providers in Bridgeport, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.