Provider Demographics
NPI:1992023808
Name:SUMIKO MISSIMER, DC
Entity Type:Organization
Organization Name:SUMIKO MISSIMER, DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:MISSIMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:408-730-4763
Mailing Address - Street 1:1078 HEATHERSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-1618
Mailing Address - Country:US
Mailing Address - Phone:408-730-4763
Mailing Address - Fax:
Practice Address - Street 1:1309 S MARY AVE
Practice Address - Street 2:#105
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3050
Practice Address - Country:US
Practice Address - Phone:408-738-8610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-17
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty