MEDICARE: DR. KHASHAYAR SADEGHI D.C

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	23973	CA

General Provider Information

NPI Number	:	1447357702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KHASHAYAR SADEGHI D.C

Provider Business Mailing Address
First Line	:	3785 WILSHIRE BLVD
Second Line	:	#400
City	:	LOS ANGELES
State	:	CA
Zip	:	90010
Country	:	US
Telephone Number	:	213-385-4535
Fax Number	:	213-385-0204

Provider Business Practice Location Address
First Line	:	#3785 WILSHIRE BOULEVARD
Second Line	:	SUITE#400
City	:	LOS ANGELES
State	:	CA
Zip	:	90010
Country	:	US
Telephone Number	:	213-385-4535
Fax Number	:	213-385-0204

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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