=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518241108
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ATAMIAN CHIROPRACTIC CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2011
-----------------------------------------------------
Last Update Date | 10/12/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8215 VAN NUYS BLVD SUITE 300
-----------------------------------------------------
City | PANORAMA CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91402-4810
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-571-5538
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 210 N CENTRAL AVE 100
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91203-3519
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-571-5538
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CHIROPRACTOR
-----------------------------------------------------
Name | DR. CHRIS ATAMIAN
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 818-571-5538
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NI0013X
-----------------------------------------------------
Taxonomy Name | Independent Medical Examiner Chiropractor
-----------------------------------------------------
License Number | DC18313
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------