Provider Demographics
NPI:1518982669
Name:DHESI, JAGTAR S (DC ACHIROPRACTICCORP)
Entity Type:Individual
Prefix:DR
First Name:JAGTAR
Middle Name:S
Last Name:DHESI
Suffix:
Gender:M
Credentials:DC ACHIROPRACTICCORP
Other - Prefix:DR
Other - First Name:JAGTAR
Other - Middle Name:S
Other - Last Name:DHESI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC ACHIROPRACTICCORP
Mailing Address - Street 1:PO BOX 657
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-0657
Mailing Address - Country:US
Mailing Address - Phone:925-275-9350
Mailing Address - Fax:925-275-9390
Practice Address - Street 1:1081 MARKET PL
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4773
Practice Address - Country:US
Practice Address - Phone:925-275-9350
Practice Address - Fax:925-275-9390
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27413111N00000X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0100XChiropractic ProvidersChiropractorOccupational Health