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General NPI Number Information
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NPI Number | 1578695227
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Entity Type | Individual
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Provider Name | ROBERT ELIA DARDASHTI D.C,
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Gender | Male
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 16661 VENTURA BLVD SUITE 115
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City | ENCINO
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State | CA
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Zip | 91436-1914
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Country | US
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Telephone | 818-789-5560
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Fax | 818-789-7025
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Provider Business Mailing Address
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Address Line | 24332 SAN FERNANDO RD
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City | NEWHALL
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State | CA
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Zip | 91321-2913
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Country | US
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Telephone | 661-222-7575
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Fax | 661-222-7872
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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 | DC20870
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | DC20870
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License Number State | CA
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