Provider Demographics
NPI:1285652933
Name:HAKIMIAN, HAGOP THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:HAGOP
Middle Name:THOMAS
Last Name:HAKIMIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JACK
Other - Middle Name:THOMAS
Other - Last Name:HAKIMIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:7935 PINEVILLE CIR
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-5340
Mailing Address - Country:US
Mailing Address - Phone:510-247-1117
Mailing Address - Fax:510-247-1217
Practice Address - Street 1:24309 SOUTHLAND DR
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-1517
Practice Address - Country:US
Practice Address - Phone:510-247-1117
Practice Address - Fax:510-247-1217
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU40287Medicare UPIN
CADC0219900Medicare ID - Type Unspecified