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General NPI Number Information
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NPI Number | 1023503679
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Entity Type | Organization
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Legal Business Name | NATURE HEALTH CHIRO INC
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 29050 S WESTERN AVE STE 152
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275
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Country | US
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Telephone | 310-519-8877
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Fax | 310-519-8290
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Provider Business Mailing Address
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Address Line | PO BOX 53486
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City | IRVINE
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State | CA
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Zip | 92619-3486
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Country | US
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Telephone | 310-519-8877
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Fax | 310-519-8290
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Authorized Official
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Title or Position | OWNER
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Name | GHAZALEH MONICA MAHMOUDI
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Credential | DC. LAC
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Telephone | 310-519-8877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 18047
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 33876
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License Number State | CA
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