Provider Demographics
NPI:1336230390
Name:LADHAWALA, NIMESH N (DC)
Entity type:Individual
Prefix:DR
First Name:NIMESH
Middle Name:N
Last Name:LADHAWALA
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 1:19716 E. COLIMA ROAD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-3210
Mailing Address - Country:US
Mailing Address - Phone:909-598-7718
Mailing Address - Fax:909-595-4918
Practice Address - Street 1:19716 E. COLIMA ROAD
Practice Address - Street 2:
Practice Address - City:ROWLAND HEIGHTS,
Practice Address - State:CA
Practice Address - Zip Code:91748-3210
Practice Address - Country:US
Practice Address - Phone:909-598-7718
Practice Address - Fax:909-595-4918
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27794111N00000X
CADC0277940111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0277940Medicare ID - Type Unspecified
U88868Medicare UPIN