Provider Demographics
NPI:1902898224
Name:HIGGINS, SEAN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:MICHAEL
Last Name:HIGGINS
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 1:3784 CLAIREMONT DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-5916
Mailing Address - Country:US
Mailing Address - Phone:858-272-0074
Mailing Address - Fax:858-272-7574
Practice Address - Street 1:3784 CLAIREMONT DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-5916
Practice Address - Country:US
Practice Address - Phone:858-272-0074
Practice Address - Fax:858-272-7574
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24860111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC24860Medicare ID - Type Unspecified
U68208Medicare UPIN