=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235002403
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANAHID EKMEKDJIAN DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/24/2025
-----------------------------------------------------
Last Update Date | 09/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13701 RIVERSIDE DR STE 747
-----------------------------------------------------
City | SHERMAN OAKS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91423-2449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-616-9355
-----------------------------------------------------
Fax | 818-616-9332
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2763 SANBORN AVE
-----------------------------------------------------
City | LA CRESCENTA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91214-2922
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-415-9223
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | DC30891
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------