Provider Demographics
NPI:1558945493
Name:SOHAM, VIVEK (DC, CME)
Entity Type:Individual
Prefix:DR
First Name:VIVEK
Middle Name:
Last Name:SOHAM
Suffix:
Gender:M
Credentials:DC, CME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12335 WORLD TRADE DR STE 1A
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-3783
Mailing Address - Country:US
Mailing Address - Phone:858-432-3072
Mailing Address - Fax:
Practice Address - Street 1:12335 WORLD TRADE DR STE 1A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-3783
Practice Address - Country:US
Practice Address - Phone:858-432-3072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor