Provider Demographics
NPI:1669557971
Name:ZENIMURA, KIRK S (DC)
Entity type:Individual
Prefix:DR
First Name:KIRK
Middle Name:S
Last Name:ZENIMURA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15520 ROCKFIELD BLVD A200
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-6705
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:5430 N PALM AVE
Practice Address - Street 2:106
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1900
Practice Address - Country:US
Practice Address - Phone:559-438-4141
Practice Address - Fax:559-438-4150
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16598111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0165980OtherBLUE SHIELD
CAT06200Medicare UPIN
CADC0165980Medicare ID - Type Unspecified