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General NPI Number Information
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NPI Number | 1053531285
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Entity Type | Organization
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Legal Business Name | CHIRO & SPORTS CARE CENTER
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Dates
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Enumeration Date | 04/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2595 E WASHINGTON BLVD SUITE 103
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City | PASADENA
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State | CA
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Zip | 91107-1409
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Country | US
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Telephone | 626-794-4227
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Fax | 626-798-7458
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Provider Business Mailing Address
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Address Line | 2595 E WASHINGTON BLVD SUITE 103
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City | PASADENA
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State | CA
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Zip | 91107-1409
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Country | US
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Telephone | 626-794-4227
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Fax | 626-798-7458
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Authorized Official
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Title or Position | OWNER CHIROPRACTOR
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Name | DR. DIKO APARDIAN
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Credential | DC
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Telephone | 626-794-4227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC21801
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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 | C21801
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License Number State | CA
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