Provider Demographics
NPI:1851312524
Name:SEDGHINEJAD, ABDOLLAH (DC)
Entity Type:Individual
Prefix:DR
First Name:ABDOLLAH
Middle Name:
Last Name:SEDGHINEJAD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ABDI
Other - Middle Name:S
Other - Last Name:NEJAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:30911 UNION CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-2547
Mailing Address - Country:US
Mailing Address - Phone:510-475-1858
Mailing Address - Fax:510-475-1885
Practice Address - Street 1:30911 UNION CITY BLVD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-2547
Practice Address - Country:US
Practice Address - Phone:510-475-1858
Practice Address - Fax:510-475-1885
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29099111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0290990Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER