Provider Demographics
NPI:1144538711
Name:BAGHDASARIAN, ANNETTE (DC)
Entity type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:
Last Name:BAGHDASARIAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25200 CARLOS BEE BLVD
Mailing Address - Street 2:560
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94542-1520
Mailing Address - Country:US
Mailing Address - Phone:415-722-2039
Mailing Address - Fax:
Practice Address - Street 1:25200 CARLOS BEE BLVD
Practice Address - Street 2:560
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94542-1520
Practice Address - Country:US
Practice Address - Phone:415-722-2039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 31714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor