Provider Demographics
NPI:1114107901
Name:DARRICK E SAHARA DC INC
Entity Type:Organization
Organization Name:DARRICK E SAHARA DC INC
Other - Org Name:SAHARA CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTIC KINESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRICK
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAHARA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-796-6830
Mailing Address - Street 1:221 E WALNUT ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1585
Mailing Address - Country:US
Mailing Address - Phone:626-796-6830
Mailing Address - Fax:626-796-6950
Practice Address - Street 1:221 E WALNUT ST
Practice Address - Street 2:SUITE 130
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1585
Practice Address - Country:US
Practice Address - Phone:626-796-6830
Practice Address - Fax:626-796-6950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28999305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization