Provider Demographics
NPI:1942498423
Name:DR ADIB ASHRAF DC CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:DR ADIB ASHRAF DC CHIROPRACTIC CORPORATION
Other - Org Name:BODY BALANCE HEALTH CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADIB
Authorized Official - Middle Name:A
Authorized Official - Last Name:ASHRAF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-358-0838
Mailing Address - Street 1:2516 SAMARITAN DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4108
Mailing Address - Country:US
Mailing Address - Phone:408-358-0838
Mailing Address - Fax:408-358-0862
Practice Address - Street 1:2516 SAMARITAN DR
Practice Address - Street 2:SUITE F
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4108
Practice Address - Country:US
Practice Address - Phone:408-358-0838
Practice Address - Fax:408-358-0862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27716111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1043240880OtherINDIVIDUAL NPI
CAZZZ03872ZMedicare UPIN