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General NPI Number Information
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NPI Number | 1770727539
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Entity Type | Organization
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Legal Business Name | HEALTH QUEST WELLNESS GROUP, INC.
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 04/23/2009
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Provider Practice Location Address
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Address Line | 815 E COLORADO ST STE 250
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City | GLENDALE
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State | CA
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Zip | 91205-4510
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Country | US
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Telephone | 818-246-3600
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Fax | 818-246-3604
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Provider Business Mailing Address
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Address Line | 815 E COLORADO ST STE 250
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City | GLENDALE
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State | CA
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Zip | 91205-4510
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Country | US
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Telephone | 818-246-3600
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Fax | 818-246-3604
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. ALFRED A BAGRYAN
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Credential | D.C.
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Telephone | 818-500-8340
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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 | DC-30481
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License Number State | CA
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