Provider Demographics
NPI:1760501035
Name:SAKER, GRACE
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:SAKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:SAKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:523 WOODWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-5717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:909 S SANTA ANITA AVE
Practice Address - Street 2:SUITE H
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-2360
Practice Address - Country:US
Practice Address - Phone:626-462-1956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25615111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor