MEDICARE: CHIRO & SPORTS CARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC21801	CA
2	111N00000X	Chiropractor	C21801	CA

General Provider Information

NPI Number	:	1053531285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIRO & SPORTS CARE CENTER

Provider Business Mailing Address
First Line	:	2595 E WASHINGTON BLVD
Second Line	:	SUITE 103
City	:	PASADENA
State	:	CA
Zip	:	91107-1409
Country	:	US
Telephone Number	:	626-794-4227
Fax Number	:	626-798-7458

Provider Business Practice Location Address
First Line	:	2595 E WASHINGTON BLVD
Second Line	:	SUITE 103
City	:	PASADENA
State	:	CA
Zip	:	91107-1409
Country	:	US
Telephone Number	:	626-794-4227
Fax Number	:	626-798-7458

Authorized Official
Title or Position	:	OWNER CHIROPRACTOR
Name	:	DR. DIKO APARDIAN
Credential	:	DC
Telephone Number	:	626-794-4227

Provider Enumeration Date	:	04/30/2007
Last Update Date	:	08/22/2020

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Directions to “CHIRO & SPORTS CARE CENTER ” Practice Location

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