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General NPI Number Information
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NPI Number | 1588846372
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Entity Type | Organization
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Legal Business Name | OMID OKHOWAT CHIROPRACTIC INC
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 6221 WILSHIRE BLVD STE 326
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City | LOS ANGELES
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State | CA
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Zip | 90048-5225
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Country | US
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Telephone | 323-933-3357
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Fax | 323-933-1116
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Provider Business Mailing Address
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Address Line | 6221 WILSHIRE BLVD STE 326
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City | LOS ANGELES
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State | CA
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Zip | 90048-5224
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Country | US
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Telephone | 323-933-3357
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Fax | 323-933-1116
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. OMID OKHOWAT
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Credential | D.C.
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Telephone | 323-933-3357
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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 | DC26462
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License Number State | CA
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