Healthcare Provider Details

I. General information

NPI: 1528093564
Provider Name (Legal Business Name): AARON MICHAEL SHAKARIAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 02/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 S. ROBERTSON BLVD.
BEVERLY HILLS CA
90211
US

IV. Provider business mailing address

PO BOX 69A03
WEST HOLLYWOOD CA
90069
US

V. Phone/Fax

Practice location:
  • Phone: 310-854-1877
  • Fax: 310-289-9863
Mailing address:
  • Phone: 310-854-1877
  • Fax: 310-289-9863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC28285
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: