Provider Demographics
NPI:1063724060
Name:JAIN, BHARAT (DC)
Entity type:Individual
Prefix:
First Name:BHARAT
Middle Name:
Last Name:JAIN
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 1:22209 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303
Mailing Address - Country:US
Mailing Address - Phone:818-835-9517
Mailing Address - Fax:818-835-9518
Practice Address - Street 1:22209 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1048
Practice Address - Country:US
Practice Address - Phone:818-835-9517
Practice Address - Fax:818-835-9518
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31705111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor