Provider Demographics
NPI:1831113554
Name:HIFAI, SAMIA H (DC)
Entity Type:Individual
Prefix:DR
First Name:SAMIA
Middle Name:H
Last Name:HIFAI
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 1:7805 HIGHLAND VILLAGE PL STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-5181
Mailing Address - Country:US
Mailing Address - Phone:858-360-9000
Mailing Address - Fax:858-360-9002
Practice Address - Street 1:995 GATEWAY CENTER WAY STE 107
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-4551
Practice Address - Country:US
Practice Address - Phone:619-264-1000
Practice Address - Fax:619-264-4404
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28677111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU98916Medicare UPIN
CADC28677BMedicare PIN