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General NPI Number Information
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NPI Number | 1619162716
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Entity Type | Individual
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Provider Name | SHAHRIAR S RAD D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 8349 RESEDA BLVD SUITE A
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4622
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Country | US
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Telephone | 818-701-9868
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Fax | 818-701-9898
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Provider Business Mailing Address
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Address Line | 8349 RESEDA BLVD SUITE A
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City | NORTHRIDGE
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State | CA
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Zip | 91324-4622
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Country | US
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Telephone | 818-701-9868
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Fax | 818-701-9898
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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 | 21478
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License Number State | CA
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