Provider Demographics
NPI:1730210758
Name:YILDIZHAN, SUSAN H (DC)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:H
Last Name:YILDIZHAN
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 1:1155 3RD ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-2663
Mailing Address - Country:US
Mailing Address - Phone:925-575-7596
Mailing Address - Fax:
Practice Address - Street 1:1155 3RD ST
Practice Address - Street 2:SUITE 130
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-2663
Practice Address - Country:US
Practice Address - Phone:925-575-7596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor