Provider Demographics
NPI:1700516572
Name:JASDEEP HENSHAW, D.C.
Entity Type:Organization
Organization Name:JASDEEP HENSHAW, D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-453-0366
Mailing Address - Street 1:PO BOX 1176
Mailing Address - Street 2:
Mailing Address - City:CARDIFF
Mailing Address - State:CA
Mailing Address - Zip Code:92007-7176
Mailing Address - Country:US
Mailing Address - Phone:858-509-7999
Mailing Address - Fax:
Practice Address - Street 1:5230 CARROLL CANYON RD STE 204
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1780
Practice Address - Country:US
Practice Address - Phone:858-453-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty