Healthcare Provider Details

I. General information

NPI: 1447826052
Provider Name (Legal Business Name): FAZEL CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2021
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3579 ARLINGTON AVE SUITE #100
RIVERSIDE CA
92506
US

IV. Provider business mailing address

3579 ARLINGTON AVE SUITE #100
RIVERSIDE CA
92506
US

V. Phone/Fax

Practice location:
  • Phone: 951-782-8369
  • Fax: 951-782-8378
Mailing address:
  • Phone: 951-782-8369
  • Fax: 951-782-8378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. SANAM FAZEL
Title or Position: PRESIDENT
Credential: DC
Phone: 951-782-8369