Provider Demographics
NPI:1407868573
Name:SHAKIB-SAFFARI, MARJAN (DC)
Entity Type:Individual
Prefix:MRS
First Name:MARJAN
Middle Name:
Last Name:SHAKIB-SAFFARI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:MARJAN
Other - Middle Name:
Other - Last Name:SAFFARI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:555 VETERANS BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063
Mailing Address - Country:US
Mailing Address - Phone:650-369-7304
Mailing Address - Fax:650-369-0584
Practice Address - Street 1:555 VETERANS BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063
Practice Address - Country:US
Practice Address - Phone:650-369-7304
Practice Address - Fax:650-369-0584
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor