Healthcare Provider Details
I. General information
NPI: 1861753675
Provider Name (Legal Business Name): ABGARYAN CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/07/2012
Last Update Date: 06/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8607 IMPERIAL HWY SUITE 400
DOWNEY CA
90242-3947
US
IV. Provider business mailing address
9245 LAGUNA SPRINGS DR SUITE 200
ELK GROVE CA
95758-7987
US
V. Phone/Fax
- Phone: 916-905-7129
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC31925 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
CHRISTINE
ABGARYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-923-0550