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General NPI Number Information
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NPI Number | 1891933586
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Entity Type | Organization
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Legal Business Name | OPTIMUM HEALTH CHIROPRACTIC
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 20335 VENTURA BLVD STE. 108
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2444
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Country | US
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Telephone | 818-704-1662
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Fax | 818-884-6795
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Provider Business Mailing Address
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Address Line | 20335 VENTURA BLVD STE. 108
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-2444
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Country | US
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Telephone | 818-704-1662
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Fax | 818-884-6795
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Authorized Official
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Title or Position | OWNER
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Name | DR. GAGIK ALVANDIAN
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Credential | D.C.
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Telephone | 818-704-1662
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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 | DC26266
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License Number State | CA
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