Provider Demographics
NPI:1578036810
Name:JAAF, RANJ
Entity Type:Individual
Prefix:
First Name:RANJ
Middle Name:
Last Name:JAAF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 S WALNUT AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5367
Mailing Address - Country:US
Mailing Address - Phone:215-584-7449
Mailing Address - Fax:
Practice Address - Street 1:6828 STREETER AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-2256
Practice Address - Country:US
Practice Address - Phone:951-374-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34332111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor