Provider Demographics
NPI:1396775094
Name:LIENHART, PAUL J (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:LIENHART
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 1:1190 SOUTH BASCOM AVE.
Mailing Address - Street 2:SUITE 212
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3512
Mailing Address - Country:US
Mailing Address - Phone:408-885-1999
Mailing Address - Fax:408-885-9595
Practice Address - Street 1:1190 SOUTH BASCOM AVE.
Practice Address - Street 2:SUITE 212
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3512
Practice Address - Country:US
Practice Address - Phone:408-885-1999
Practice Address - Fax:408-885-9595
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA016-469111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor