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General NPI Number Information
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NPI Number | 1710175682
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Entity Type | Organization
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Legal Business Name | MIRZAIANS CHIROPRACTIC & PHYSICAL REHABILITATION SERVICES, INC.
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 3680 E IMPERIAL HWY STE 240
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City | LYNWOOD
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State | CA
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Zip | 90262-2673
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Country | US
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Telephone | 310-537-7600
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Fax | 310-537-9438
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Provider Business Mailing Address
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Address Line | 3680 E IMPERIAL HWY STE 240
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City | LYNWOOD
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State | CA
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Zip | 90262-2673
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Country | US
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Telephone | 310-537-7600
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Fax | 310-537-9438
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Authorized Official
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Title or Position | PRESIDENT
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Name | ARBI MIRZAIANS
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Credential | D.C.
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Telephone | 310-537-7600
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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 | DC29482
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License Number State | CA
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