Healthcare Provider Details
I. General information
NPI: 1932381837
Provider Name (Legal Business Name): SALEHMOHAMED CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/03/2007
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
321 N LARCHMONT BLVD SUITE #905
LOS ANGELES CA
90004-3025
US
IV. Provider business mailing address
321 N LARCHMONT BLVD SUITE #905
LOS ANGELES CA
90004-3025
US
V. Phone/Fax
- Phone: 310-736-1480
- Fax: 310-736-1481
- Phone: 310-736-1480
- Fax: 310-736-1481
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC29606 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
RAHIM
SALEHMOHAMED
Title or Position: PRESIDENT
Credential: D.C.
Phone: 310-736-1480