Healthcare Provider Details

I. General information

NPI: 1962427724
Provider Name (Legal Business Name): AMIN NIA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5211 E. WASHINGTON BLVD. SECOND FLOOR
COMMERCE CA
90040
US

IV. Provider business mailing address

2083 RIDGE POINT DR
LOS ANGELES CA
90049-6854
US

V. Phone/Fax

Practice location:
  • Phone: 323-980-9002
  • Fax: 323-980-9898
Mailing address:
  • Phone: 714-293-4571
  • Fax: 310-471-9521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 21989
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: