Healthcare Provider Details

I. General information

NPI: 1104074087
Provider Name (Legal Business Name): CHALIKIAN CHIROPRACTIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 09/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 E WALNUT ST STE 275
PASADENA CA
91101-6001
US

IV. Provider business mailing address

221 E WALNUT ST STE 275
PASADENA CA
91101-6001
US

V. Phone/Fax

Practice location:
  • Phone: 626-765-0555
  • Fax: 626-765-0248
Mailing address:
  • Phone: 626-765-0555
  • Fax: 626-765-0248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License NumberDC28350
License Number StateCA

VIII. Authorized Official

Name: DR. ALICE CHALIKIAN
Title or Position: PRESIDENT, DC
Credential: D.C.
Phone: 626-765-0555