Provider Demographics
NPI:1659481703
Name:STRAHAN, REID (DC)
Entity Type:Individual
Prefix:DR
First Name:REID
Middle Name:
Last Name:STRAHAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 PASEO DEL NORTE
Mailing Address - Street 2:E-1
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1150
Mailing Address - Country:US
Mailing Address - Phone:760-438-1114
Mailing Address - Fax:760-438-5694
Practice Address - Street 1:6120 PASEO DEL NORTE
Practice Address - Street 2:E-1
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-1150
Practice Address - Country:US
Practice Address - Phone:760-438-1114
Practice Address - Fax:760-438-5694
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14777111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC14777Medicare UPIN
CADC14777Medicare ID - Type Unspecified