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General NPI Number Information
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NPI Number | 1306481825
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Entity Type | Individual
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Provider Name | AFSANEH DERAKHSHAN
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Gender | Female
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Dates
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Enumeration Date | 11/07/2019
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Last Update Date | 11/07/2019
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Provider Practice Location Address
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Address Line | 12217 PHILADELPHIA ST
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City | WHITTIER
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State | CA
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Zip | 90601-3931
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Country | US
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Telephone | 562-822-7928
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Fax |
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Provider Business Mailing Address
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Address Line | 9213 FIREBIRD AVE
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City | WHITTIER
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State | CA
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Zip | 90605-2534
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 34487
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License Number State | CA
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