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General NPI Number Information
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NPI Number | 1598804114
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Entity Type | Individual
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Provider Name | AZITA TABASSIAN D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 11/05/2017
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Provider Practice Location Address
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Address Line | 3400 LOMITA BLVD STE 502
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City | TORRANCE
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State | CA
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Zip | 90505-4988
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Country | US
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Telephone | 310-346-3207
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Fax |
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Provider Business Mailing Address
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Address Line | 30055 AVENIDA ESPLENDIDA
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City | RANCHO PALOS VERDES
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State | CA
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Zip | 90275-5420
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Country | US
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Telephone | 310-346-3207
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Fax |
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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 | DC26152
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License Number State | CA
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