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General NPI Number Information
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NPI Number | 1407253354
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Entity Type | Organization
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Legal Business Name | MIRAMADI CHIROPRACTIC A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/20/2014
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Last Update Date | 03/04/2023
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Provider Practice Location Address
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Address Line | 1122 E LINCOLN AVE STE B200
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City | ORANGE
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State | CA
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Zip | 92865-1918
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Country | US
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Telephone | 714-602-7479
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Fax | 714-602-7408
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Provider Business Mailing Address
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Address Line | PO BOX 17633
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City | ANAHEIM
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State | CA
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Zip | 92817-7633
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Country | US
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Telephone | 714-602-7479
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Fax | 714-602-7408
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MANDANA MIRAMADI
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Credential | DC
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Telephone | 714-602-7479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DC 33004
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License Number State | CA
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