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General NPI Number Information
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NPI Number | 1891197034
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Entity Type | Organization
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Legal Business Name | KUPELIAN CHIROPRACTIC HEALTH CENTER, INC.
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 01/06/2016
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Provider Practice Location Address
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Address Line | 1332 S GLENDALE AVE
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City | GLENDALE
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State | CA
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Zip | 91205-3349
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Country | US
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Telephone | 818-484-8901
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Fax | 818-484-8902
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Provider Business Mailing Address
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Address Line | 1332 S GLENDALE AVE
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City | GLENDALE
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State | CA
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Zip | 91205-3349
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Country | US
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Telephone | 818-484-8901
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Fax | 818-484-8902
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Authorized Official
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Title or Position | CEO
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Name | DR. ASDGHIK STAR KUPELIAN
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Credential | D.C
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Telephone | 18184848901
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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 | 32680
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License Number State | CA
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