Provider Demographics
NPI:1497808299
Name:BHAKTA, JIGNESH B (DC)
Entity Type:Individual
Prefix:
First Name:JIGNESH
Middle Name:B
Last Name:BHAKTA
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 1:7850 STOCKTON BLVD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-4319
Mailing Address - Country:US
Mailing Address - Phone:916-689-3200
Mailing Address - Fax:916-689-1808
Practice Address - Street 1:7850 STOCKTON BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-4319
Practice Address - Country:US
Practice Address - Phone:916-689-3200
Practice Address - Fax:916-689-1808
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA 22595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA 22595OtherLICENSE NUMBER
CACA 22595OtherLICENSE NUMBER