Healthcare Provider Details

I. General information

NPI: 1790235406
Provider Name (Legal Business Name): BLIKIAN CHIROPRACTIC AND ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2016
Last Update Date: 10/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 VICTORY BLVD
GLENDALE CA
91201-2915
US

IV. Provider business mailing address

1600 VICTORY BLVD
GLENDALE CA
91201-2915
US

V. Phone/Fax

Practice location:
  • Phone: 818-244-5300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC31726
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC17070
License Number StateCA

VIII. Authorized Official

Name: DR. HAGOP BLIKIAN
Title or Position: PRESIDENT
Credential: DC
Phone: 818-244-5300