Provider Demographics
NPI:1669638474
Name:NASIF, CAROLINE EGAN (DC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:EGAN
Last Name:NASIF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7877 PARKWAY DR STE 2C
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-2000
Mailing Address - Country:US
Mailing Address - Phone:619-462-4202
Mailing Address - Fax:
Practice Address - Street 1:7877 PARKWAY DR STE 2C
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2000
Practice Address - Country:US
Practice Address - Phone:619-462-4202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20962111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor