Healthcare Provider Details

I. General information

NPI: 1205957255
Provider Name (Legal Business Name): NAZEE ROFAGHA CHIROPRACTOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 S CHESTER AVE # 102
PASADENA CA
91106-3104
US

IV. Provider business mailing address

99 S CHESTER AVE # 102
PASADENA CA
91106-3104
US

V. Phone/Fax

Practice location:
  • Phone: 626-583-9116
  • Fax: 626-583-9115
Mailing address:
  • Phone: 626-583-9116
  • Fax: 626-583-9115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC23582
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: