Provider Demographics
NPI:1477625697
Name:SAKIN, NAOMI GHANDOUR (DC)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:GHANDOUR
Last Name:SAKIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:NAOMI
Other - Middle Name:
Other - Last Name:GHANDOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2812 SOARING PEAK AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-7703
Mailing Address - Country:US
Mailing Address - Phone:702-463-3626
Mailing Address - Fax:
Practice Address - Street 1:10624 S EASTERN AVE
Practice Address - Street 2:ST. Q
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2982
Practice Address - Country:US
Practice Address - Phone:702-463-3626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29882111N00000X
NVB01406111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor