Provider Demographics
NPI:1992983928
Name:NAMBUDRIPAD, DEVI S (DC, LAC, PHD)
Entity type:Individual
Prefix:DR
First Name:DEVI
Middle Name:S
Last Name:NAMBUDRIPAD
Suffix:
Gender:F
Credentials:DC, LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6714 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-3410
Mailing Address - Country:US
Mailing Address - Phone:714-523-8900
Mailing Address - Fax:714-523-3068
Practice Address - Street 1:6714 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-3410
Practice Address - Country:US
Practice Address - Phone:714-523-8900
Practice Address - Fax:714-523-3068
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16776111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC16776Medicare PIN