Provider Demographics
NPI:1265506018
Name:NILCHAVEE, SAHARUT (DC)
Entity Type:Individual
Prefix:DR
First Name:SAHARUT
Middle Name:
Last Name:NILCHAVEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 W VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-2323
Mailing Address - Country:US
Mailing Address - Phone:626-300-9248
Mailing Address - Fax:
Practice Address - Street 1:1519 W VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-2323
Practice Address - Country:US
Practice Address - Phone:626-300-9248
Practice Address - Fax:626-282-0992
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor