Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 22693 | CA |
N | 111NX0100X | Occupational Health | 22693 | CA |
NPI | 1598053431 |
---|---|
Provider Name | Omid Haghighinia |
First Address | Tustin, CA 92780-3329 |
Second Address | Tustin, CA 92780-3329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2011 |
Last Update Date | 13/07/2011 |