Healthcare Provider Details

I. General information

NPI: 1982867586
Provider Name (Legal Business Name): SUPERIOR CHIROPRACTIC CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14328 VICTORY BLVD #G
VAN NUYS CA
91401-1946
US

IV. Provider business mailing address

PO BOX 251
WOODLAND HILLS CA
91365-0251
US

V. Phone/Fax

Practice location:
  • Phone: 818-902-2122
  • Fax: 818-902-2151
Mailing address:
  • Phone: 818-902-2122
  • Fax: 818-902-2151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberDC23513
License Number StateCA

VIII. Authorized Official

Name: DR. SHIVA DRAKHSHANI
Title or Position: PRESIDENT
Credential: D.C.
Phone: 818-902-2122