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General NPI Number Information
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NPI Number | 1467722231
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Entity Type | Individual
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Provider Name | SETAREH DERAKHSHAN D.C.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2012
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Last Update Date | 08/14/2015
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Provider Practice Location Address
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Address Line | 221E WALNUT ST 275
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City | PASADENA
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State | CA
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Zip | 91101-6001
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Country | US
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Telephone | 626-765-0555
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Fax | 626-765-0248
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Provider Business Mailing Address
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Address Line | 1533 SHATTUCK AVE STE A
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City | BERKELEY
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State | CA
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Zip | 94709-1516
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Country | US
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Telephone | 678-993-3196
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Fax | 510-666-0312
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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 | 32007
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License Number State | CA
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