Provider Demographics
NPI:1831678770
Name:MIRY, SAYED NAWEED (DC)
Entity Type:Individual
Prefix:DR
First Name:SAYED
Middle Name:NAWEED
Last Name:MIRY
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 1:1031 ROLLING WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-5423
Mailing Address - Country:US
Mailing Address - Phone:925-301-7739
Mailing Address - Fax:
Practice Address - Street 1:500 BOLLINGER CANYON WAY STE A15
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582-5297
Practice Address - Country:US
Practice Address - Phone:925-301-7739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34094111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor