Provider Demographics
NPI:1578581732
Name:ELCHAMI, TAREK
Entity Type:Individual
Prefix:DR
First Name:TAREK
Middle Name:
Last Name:ELCHAMI
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 1:2910 STEVENS CREEK BLVD
Mailing Address - Street 2:STE 209
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2015
Mailing Address - Country:US
Mailing Address - Phone:408-476-6344
Mailing Address - Fax:
Practice Address - Street 1:2910 STEVENS CREEK BLVD STE 209
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2015
Practice Address - Country:US
Practice Address - Phone:408-476-6344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27051111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor