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General NPI Number Information
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NPI Number | 1588945950
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Entity Type | Organization
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Legal Business Name | MED-LEGAL SAFAEIAN CHIROPRACTIC AND PHYSICAL THERAPY GROUP INC
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Dates
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Enumeration Date | 08/30/2011
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 426 E ARBOR VITAE ST
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City | INGLEWOOD
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State | CA
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Zip | 90301-3450
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Country | US
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Telephone | 310-672-4110
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Fax | 310-672-0181
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Provider Business Mailing Address
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Address Line | 426 E ARBOR VITAE ST
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City | INGLEWOOD
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State | CA
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Zip | 90301-3450
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Country | US
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Telephone | 310-672-4110
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Fax | 310-672-0181
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MASOUD SAFAEIAN
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Credential | DC
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Telephone | 310-672-4110
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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 | DC27287
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License Number State | CA
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