Provider Demographics
NPI:1922439645
Name:DEENA HAKIM DC LLC
Entity Type:Organization
Organization Name:DEENA HAKIM DC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:831-747-4578
Mailing Address - Street 1:222 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:93950-3319
Mailing Address - Country:US
Mailing Address - Phone:831-747-4578
Mailing Address - Fax:831-375-5562
Practice Address - Street 1:222 FOREST AVE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-3319
Practice Address - Country:US
Practice Address - Phone:831-747-4578
Practice Address - Fax:831-375-5562
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEENA HAKIM DC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0280780111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty