Provider Demographics
NPI:1316991284
Name:TA, KHOI BA III (CHIROPRACTOR)
Entity type:Individual
Prefix:DR
First Name:KHOI
Middle Name:BA
Last Name:TA
Suffix:III
Gender:M
Credentials:CHIROPRACTOR
Other - Prefix:
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Mailing Address - Street 1:5850 STOCKTON BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95824-3016
Mailing Address - Country:US
Mailing Address - Phone:916-427-8200
Mailing Address - Fax:916-391-6087
Practice Address - Street 1:5850 STOCKTON BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95824-3016
Practice Address - Country:US
Practice Address - Phone:916-427-8200
Practice Address - Fax:916-391-6087
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA25627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor