Provider Demographics
NPI:1770037673
Name:CSAKAI, COREY J (DC)
Entity Type:Individual
Prefix:DR
First Name:COREY
Middle Name:J
Last Name:CSAKAI
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 1:210 E FLAMINGO RD UNIT 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-4797
Mailing Address - Country:US
Mailing Address - Phone:908-692-3460
Mailing Address - Fax:
Practice Address - Street 1:3645 S RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-1057
Practice Address - Country:US
Practice Address - Phone:732-444-8114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-09
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00736700111N00000X
NVB01877111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ38MC00736700OtherLICENSE NUMBER
1770037673OtherNATIONAL PROVIDER IDENTIFIER