Provider Demographics
NPI:1174742118
Name:HOWARD J ESSEGIAN DC A CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:HOWARD J ESSEGIAN DC A CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ESSEGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:831-423-4668
Mailing Address - Street 1:116 DOYLE STREET
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2117
Mailing Address - Country:US
Mailing Address - Phone:831-423-4668
Mailing Address - Fax:831-423-4668
Practice Address - Street 1:116 DOYLE STREET
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2117
Practice Address - Country:US
Practice Address - Phone:831-423-4668
Practice Address - Fax:831-423-4668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TO3303Medicare UPIN
CADC0070400Medicare ID - Type Unspecified