Provider Demographics
NPI:1336295401
Name:POLADIAN, DONALD A (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:A
Last Name:POLADIAN
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 1:488 W SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2511
Mailing Address - Country:US
Mailing Address - Phone:559-227-0995
Mailing Address - Fax:559-227-0904
Practice Address - Street 1:488 W SHAW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2511
Practice Address - Country:US
Practice Address - Phone:559-227-0995
Practice Address - Fax:559-227-0904
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2010-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA11501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor