Provider Demographics
NPI:1992997092
Name:HIRAMINE, JIM (DC)
Entity type:Individual
Prefix:DR
First Name:JIM
Middle Name:
Last Name:HIRAMINE
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:PO BOX 482
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-0482
Mailing Address - Country:US
Mailing Address - Phone:925-820-4545
Mailing Address - Fax:925-820-4546
Practice Address - Street 1:822 HARTZ WAY
Practice Address - Street 2:SUITE 108
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-3433
Practice Address - Country:US
Practice Address - Phone:925-820-4545
Practice Address - Fax:925-820-4546
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 14396111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0143960Medicare PIN