Provider Demographics
NPI:1629222609
Name:ZENIMURA CHIROPRACTIC
Entity Type:Organization
Organization Name:ZENIMURA CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENIMURA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:559-438-4141
Mailing Address - Street 1:15550 ROCKFIELD BLVD
Mailing Address - Street 2:B220
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2720
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:5430 N PALM AVE
Practice Address - Street 2:106
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1900
Practice Address - Country:US
Practice Address - Phone:559-438-4141
Practice Address - Fax:559-438-4150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0165980OtherBLUE SHIELD
CADC0165980Medicare PIN