Provider Demographics
NPI:1144410929
Name:YEGANEGI, FARIMA N (DC)
Entity Type:Individual
Prefix:DR
First Name:FARIMA
Middle Name:N
Last Name:YEGANEGI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 CAMDEN AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-2844
Mailing Address - Country:US
Mailing Address - Phone:408-377-4700
Mailing Address - Fax:408-377-4703
Practice Address - Street 1:1954 CAMDEN AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-2844
Practice Address - Country:US
Practice Address - Phone:408-377-4700
Practice Address - Fax:408-377-4703
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA019338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0193380Medicare PIN