Provider Demographics
NPI:1588726350
Name:FAYGENHOLTZ, ARTHUR SIMON (DC)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:SIMON
Last Name:FAYGENHOLTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ARTHUR
Other - Middle Name:
Other - Last Name:FAYGENHOLTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:7128 DANKO DR
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-3337
Mailing Address - Country:US
Mailing Address - Phone:831-688-1596
Mailing Address - Fax:
Practice Address - Street 1:831 BAY AVE STE 1B
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2105
Practice Address - Country:US
Practice Address - Phone:831-477-0886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ25406ZMedicare ID - Type UnspecifiedGROUP ID