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General NPI Number Information
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NPI Number | 1265629752
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Entity Type | Organization
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Legal Business Name | SOUTHERN CALIFORNIA CORF
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 18531 ROSCOE BLVD. 215
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City | NORTHRIDGE
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State | CA
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Zip | 91324
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Country | US
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Telephone | 818-700-0478
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Fax | 818-975-9995
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Provider Business Mailing Address
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Address Line | 11024 BALBOA BLVD. 504
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City | GRANADA HILLS
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State | CA
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Zip | 91344
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Country | US
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Telephone | 818-700-0478
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Fax | 818-700-0475
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARA TEPELEKIAN
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Credential | D.C
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Telephone | 818-700-0478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number |
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License Number State |
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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 | DC 27178
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC27178
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT28631
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License Number State | CA
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