Provider Demographics
NPI:1902290273
Name:JOSEPH BAHAN
Entity Type:Organization
Organization Name:JOSEPH BAHAN
Other - Org Name:HARBOR CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:D,C,
Authorized Official - Phone:949-525-3550
Mailing Address - Street 1:23 OBISPO
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-3171
Mailing Address - Country:US
Mailing Address - Phone:949-525-3550
Mailing Address - Fax:
Practice Address - Street 1:800 S PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3265
Practice Address - Country:US
Practice Address - Phone:310-547-8488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20506111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty