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General NPI Number Information
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NPI Number | 1518039080
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Entity Type | Organization
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Legal Business Name | NASRIN MOGHADASIAN CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 11/28/2011
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Provider Practice Location Address
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Address Line | 412 S PACIFIC COAST HWY STE. 100
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City | REDONDO BEACH
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State | CA
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Zip | 90277-3735
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Country | US
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Telephone | 310-792-9100
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Fax | 310-792-1180
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Provider Business Mailing Address
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Address Line | 412 S PACIFIC COAST HWY STE. 100
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City | REDONDO BEACH
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State | CA
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Zip | 90277-3735
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Country | US
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Telephone | 310-792-9100
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Fax | 310-792-1180
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MICHELLE VILLA
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Credential |
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Telephone | 805-474-9053
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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 | DC27488
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License Number State | CA
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