Healthcare Provider Details

I. General information

NPI: 1275707341
Provider Name (Legal Business Name): KARINE JEGHELIAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2008
Last Update Date: 04/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 E COLORADO ST #110A
GLENDALE CA
91205-1200
US

IV. Provider business mailing address

815 E COLORADO ST #110A
GLENDALE CA
91205-1200
US

V. Phone/Fax

Practice location:
  • Phone: 818-242-1910
  • Fax: 818-242-1990
Mailing address:
  • Phone: 818-242-1910
  • Fax: 818-242-1990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC30129
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: