Provider Demographics
NPI:1386989622
Name:NIKKHOO, RAMIN (DC)
Entity type:Individual
Prefix:DR
First Name:RAMIN
Middle Name:
Last Name:NIKKHOO
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 1:75-5660 KOPIKO ST
Mailing Address - Street 2:C7-280
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-3611
Mailing Address - Country:US
Mailing Address - Phone:808-854-1360
Mailing Address - Fax:
Practice Address - Street 1:75-5660 KOPIKO ST
Practice Address - Street 2:C7-280
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-3611
Practice Address - Country:US
Practice Address - Phone:808-854-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1035111N00000X
CA25770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU78394Medicare UPIN