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General NPI Number Information
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NPI Number | 1194965103
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Entity Type | Individual
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Provider Name | JASON MATTHEW HIGGINS D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 08/07/2011
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Provider Practice Location Address
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Address Line | 2745 JEFFERSON ST SUITE A
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City | CARLSBAD
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State | CA
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Zip | 92008-1742
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Country | US
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Telephone | 760-434-9454
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Fax | 760-434-9453
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Provider Business Mailing Address
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Address Line | 2745 JEFFERSON ST SUITE A
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City | CARLSBAD
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State | CA
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Zip | 92008-1742
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Country | US
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Telephone | 760-434-9454
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Fax | 760-434-9453
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 31148
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License Number State | CA
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