Provider Demographics
NPI:1750326781
Name:HIMINKOOL, JOHN S (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:HIMINKOOL
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 1:4235 CONVOY ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-3703
Mailing Address - Country:US
Mailing Address - Phone:858-715-9400
Mailing Address - Fax:858-715-9550
Practice Address - Street 1:4235 CONVOY ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3703
Practice Address - Country:US
Practice Address - Phone:858-715-9400
Practice Address - Fax:858-715-9550
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14539111NT0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NT0100XChiropractic ProvidersChiropractorThermography
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC14539Medicare ID - Type UnspecifiedMEDICARE ID
CAT17807Medicare UPIN