Healthcare Provider Details

I. General information

NPI: 1659163038
Provider Name (Legal Business Name): MARY AZOIAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16255 VENTURA BLVD STE 420
ENCINO CA
91436-2308
US

IV. Provider business mailing address

16255 VENTURA BLVD STE 420
ENCINO CA
91436-2308
US

V. Phone/Fax

Practice location:
  • Phone: 818-355-0585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC36582
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License NumberDC36582
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: