Provider Demographics
NPI:1740361526
Name:PARHAM, STEPHEN G (DC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:G
Last Name:PARHAM
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 1:15520 ROCKFIELD BLVD
Mailing Address - Street 2:STE A200
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-6705
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:27601 FORBES RD
Practice Address - Street 2:30
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1201
Practice Address - Country:US
Practice Address - Phone:949-348-2522
Practice Address - Fax:949-348-2428
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0217720OtherBLUE SHIELD
CAU33122Medicare UPIN
CADC21772Medicare ID - Type Unspecified