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NPI Code Detail

MEDICARE: DR. OMID ALYESHMERNI DC

MEDICARE:  DR. OMID  ALYESHMERNI  DC
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
1111N00000XChiropractor4991AZ
2111N00000XChiropractorX010908NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AZ0245210OTHERBC/BS AZ

General Provider Information

NPI Number : 1598759565
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OMID ALYESHMERNI DC
Provider Business Mailing Address
First Line : 7333 W THOMAS RD
Second Line : #40
City : PHOENIX
State : AZ
Zip : 85033-5546
Country : US
Telephone Number : 623-849-1736
Fax Number : 623-849-0406
Provider Business Practice Location Address
First Line : 7333 W THOMAS RD
Second Line : #40
City : PHOENIX
State : AZ
Zip : 85033-5546
Country : US
Telephone Number : 623-849-1736
Fax Number : 623-849-0406
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 07/08/2007

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Directions to “ DR. OMID ALYESHMERNI DC” Practice Location

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