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General NPI Number Information
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NPI Number | 1629510656
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Entity Type | Organization
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Legal Business Name | ALBERT KANDKHOROV CHIROPRACTIC CORP
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Dates
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Enumeration Date | 11/08/2016
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Last Update Date | 11/08/2016
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Provider Practice Location Address
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Address Line | 13711 VAN NUYS BLVD. SUITE 5
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City | PACOIMA
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State | CA
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Zip | 91331-3654
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Country | US
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Telephone | 818-890-6600
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Fax | 818-890-7300
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Provider Business Mailing Address
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Address Line | 13711 VAN NUYS BLVD. SUITE 5
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City | PACOIMA
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State | CA
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Zip | 91331-3654
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Country | US
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Telephone | 818-890-6600
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Fax | 818-890-7300
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALBERT KANDKHOROV
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Credential | DC
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Telephone | 818-890-6600
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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 |
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License Number State |
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