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General NPI Number Information
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NPI Number | 1497888911
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Entity Type | Organization
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Legal Business Name | BAHAR DANESH-GHARIB CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17547 VENTURA BLVD SUITE # 308-A
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City | ENCINO
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State | CA
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Zip | 91316-3853
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Country | US
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Telephone | 818-906-8972
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Fax | 818-906-8947
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Provider Business Mailing Address
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Address Line | 132 S VERMONT AVE SUITE #204
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City | LOS ANGELES
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State | CA
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Zip | 90004-5954
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Country | US
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Telephone | 213-389-2526
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Fax | 213-389-2506
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Authorized Official
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Title or Position | OWNER
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Name | DR. BAHAR DANESH GHARIB
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Credential | D.C.
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Telephone | 213-389-2526
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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 | DC28361
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License Number State | CA
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