Provider Demographics
NPI:1669747143
Name:ASAD, JOB J (DC, BSC)
Entity type:Individual
Prefix:DR
First Name:JOB
Middle Name:J
Last Name:ASAD
Suffix:
Gender:M
Credentials:DC, BSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 BOULEVARD WAY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-1125
Mailing Address - Country:US
Mailing Address - Phone:925-289-8011
Mailing Address - Fax:
Practice Address - Street 1:1280 BOULEVARD WAY
Practice Address - Street 2:SUITE 106
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-1125
Practice Address - Country:US
Practice Address - Phone:925-289-8011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34521111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician