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General NPI Number Information
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NPI Number | 1386900074
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Entity Type | Organization
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Legal Business Name | SYLMAR HEALTH CARE PROFESSIONALS MEDICAL GROUP INC.
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Dates
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Enumeration Date | 04/06/2012
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Last Update Date | 04/06/2012
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Provider Practice Location Address
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Address Line | 12737 GLENOAKS BLVD SUITE 12A
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City | SYLMAR
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State | CA
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Zip | 91342
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Country | US
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Telephone | 818-367-9068
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Fax | 818-367-9069
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Provider Business Mailing Address
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Address Line | 12737 GLENOAKS BLVD SUITE 12A
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City | SYLMAR
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State | CA
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Zip | 91342
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Country | US
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Telephone | 818-367-9068
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Fax | 818-367-9069
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. HOUSHANG DANNY PAVEHZADEH
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Credential | D.C.
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Telephone | 818-367-9068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PT7940
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 173C00000X
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Taxonomy Name | Reflexologist
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License Number | AC11667
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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 | DC29084
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License Number State | CA
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