Provider Demographics
NPI:1528076908
Name:SAHARA, CURTIS MASATO (DC)
Entity type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:MASATO
Last Name:SAHARA
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 1:17035 N 67TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-4511
Mailing Address - Country:US
Mailing Address - Phone:623-337-4630
Mailing Address - Fax:623-337-4631
Practice Address - Street 1:17035 N 67TH AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-4511
Practice Address - Country:US
Practice Address - Phone:623-337-4630
Practice Address - Fax:623-337-4631
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7345111N00000X
AZ450171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0945430OtherBLUE CROSS BLUE SHIELD
AZ7089707OtherAETNA/LANDMARK
AZ7089707OtherAETNA/LANDMARK
AZAZ0945430OtherBLUE CROSS BLUE SHIELD