Provider Demographics
NPI:1598053431
Name:HAGHIGHINIA, OMID (CHIROPRACTIC)
Entity Type:Individual
Prefix:
First Name:OMID
Middle Name:
Last Name:HAGHIGHINIA
Suffix:
Gender:M
Credentials:CHIROPRACTIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18062 IRVINE BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3329
Mailing Address - Country:US
Mailing Address - Phone:714-505-6030
Mailing Address - Fax:714-505-6032
Practice Address - Street 1:18062 IRVINE BLVD STE 206
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3329
Practice Address - Country:US
Practice Address - Phone:714-505-6030
Practice Address - Fax:714-505-6032
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22693111N00000X, 111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NX0100XChiropractic ProvidersChiropractorOccupational Health