Healthcare Provider Details

I. General information

NPI: 1730351123
Provider Name (Legal Business Name): ROFAGHA CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2008
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 S FAIR OAKS AVE
PASADENA CA
91105-2621
US

IV. Provider business mailing address

1017 S FAIR OAKS AVE
PASADENA CA
91105-2621
US

V. Phone/Fax

Practice location:
  • Phone: 626-583-9116
  • Fax: 626-403-6266
Mailing address:
  • Phone: 626-583-9116
  • Fax: 626-403-6266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. NAZEE ROFAGHA
Title or Position: OWNER
Credential: DC
Phone: 626-583-9116