=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528233640
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JINDAL CHIROPRACTIC INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2008
-----------------------------------------------------
Last Update Date | 01/26/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 939 W EL CAMINO REAL SUITE 113
-----------------------------------------------------
City | SUNNYVALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94087-6108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-730-1991
-----------------------------------------------------
Fax | 408-864-2168
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 939 W EL CAMINO REAL SUITE 113
-----------------------------------------------------
City | SUNNYVALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94087-6108
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-730-1991
-----------------------------------------------------
Fax | 408-864-2168
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR OF CHIROPRACTIC/CEO
-----------------------------------------------------
Name | DR. VID JINDAL
-----------------------------------------------------
Credential | D.C., CCSP
-----------------------------------------------------
Telephone | 408-730-1991
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC30460
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------