MEDICARE: IRON CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1043062359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IRON CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1236 E LOS ANGELES AVE STE C
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-2893
Country	:	US
Telephone Number	:	805-791-3177
Fax Number	:

Provider Business Practice Location Address
First Line	:	1236 E LOS ANGELES AVE STE C
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-2893
Country	:	US
Telephone Number	:	805-791-3177
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANIEL DEMERJIAN
Credential	:	DC
Telephone Number	:	805-791-3177

Provider Enumeration Date	:	04/02/2024
Last Update Date	:	04/02/2024

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Directions to “IRON CHIROPRACTIC ” Practice Location

Language	Start Address	Practice Location

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