Provider Demographics
NPI:1053844621
Name:HINES, SARA MCHARDY (DC)
Entity type:Individual
Prefix:MISS
First Name:SARA
Middle Name:MCHARDY
Last Name:HINES
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 1:16490 PASEO DEL SUR STE 115
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-4203
Mailing Address - Country:US
Mailing Address - Phone:858-524-1091
Mailing Address - Fax:858-524-1033
Practice Address - Street 1:16490 PASEO DEL SUR STE 115
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-4203
Practice Address - Country:US
Practice Address - Phone:858-524-1091
Practice Address - Fax:858-524-1033
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor