Healthcare Provider Details

I. General information

NPI: 1053102079
Provider Name (Legal Business Name): DAVOOD ROKNI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date: 05/23/2025
Reactivation Date: 08/12/2025

III. Provider practice location address

20502 HAMLIN ST
WINNETKA CA
91306-4102
US

IV. Provider business mailing address

20502 HAMLIN ST
WINNETKA CA
91306-4102
US

V. Phone/Fax

Practice location:
  • Phone: 818-916-9626
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number35262
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: