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General NPI Number Information
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NPI Number | 1073123618
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Entity Type | Organization
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Legal Business Name | JANDIAL CORP
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Dates
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Enumeration Date | 08/07/2020
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Last Update Date | 08/07/2020
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Provider Practice Location Address
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Address Line | 455 AVENUE ALHAMBRA # 5
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City | EL GRANADA
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State | CA
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Zip | 94018-8132
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Country | US
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Telephone | 650-726-3300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 327
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City | EL GRANADA
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State | CA
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Zip | 94018-0327
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Country | US
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Telephone | 650-726-3300
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SIDHARTHA JANDIAL
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Credential | DC
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Telephone | 650-274-5308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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