Provider Demographics
NPI:1235565334
Name:ESFAHANIZADEH, SAYYEDAH FATIMAH (DC)
Entity Type:Individual
Prefix:
First Name:SAYYEDAH FATIMAH
Middle Name:
Last Name:ESFAHANIZADEH
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 1:1130 CAMINO DEL MAR STE I
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-2639
Mailing Address - Country:US
Mailing Address - Phone:858-519-5461
Mailing Address - Fax:
Practice Address - Street 1:1130 CAMINO DEL MAR STE I
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2639
Practice Address - Country:US
Practice Address - Phone:858-519-5461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor