Provider Demographics
NPI:1710062260
Name:ARANIBAR, JORGE ANTONIO (DC)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:ANTONIO
Last Name:ARANIBAR
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 1:1119 SUNNYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-1363
Mailing Address - Country:US
Mailing Address - Phone:650-580-1706
Mailing Address - Fax:650-225-0510
Practice Address - Street 1:931 SAN BRUNO AVE W RM 7
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3435
Practice Address - Country:US
Practice Address - Phone:650-225-0540
Practice Address - Fax:650-225-0510
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor