Provider Demographics
NPI:1437220175
Name:LUEDERS, SETH B (DC)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:B
Last Name:LUEDERS
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 1:6105 SNELL AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-4739
Mailing Address - Country:US
Mailing Address - Phone:408-578-1460
Mailing Address - Fax:408-578-1804
Practice Address - Street 1:6105 SNELL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-4739
Practice Address - Country:US
Practice Address - Phone:408-578-1460
Practice Address - Fax:408-578-1804
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA943239914OtherTAX IDENTIFICATION NUMBER