Provider Demographics
NPI:1174906838
Name:ZUBIN DAH CHIROPRACTIC INC.
Entity type:Organization
Organization Name:ZUBIN DAH CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZUBIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:DAH
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:949-679-3734
Mailing Address - Street 1:10 CORPORATE PARK
Mailing Address - Street 2:SUITE 230
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-3199
Mailing Address - Country:US
Mailing Address - Phone:949-679-3734
Mailing Address - Fax:949-679-3736
Practice Address - Street 1:10 CORPORATE PARK
Practice Address - Street 2:SUITE 230
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-3199
Practice Address - Country:US
Practice Address - Phone:949-679-3734
Practice Address - Fax:949-679-3736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14661171100000X
CADC32274111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHI098ZMedicaid