MEDICARE: KHANJIAN CHIROPRACTIC, INC.

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	DC31853	CA

General Provider Information

NPI Number	:	1073894457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KHANJIAN CHIROPRACTIC, INC.

Provider Business Mailing Address
First Line	:	183 E. GLENARM STREET
Second Line	:	SUITE 104
City	:	PASADENA
State	:	CA
Zip	:	91105-3460
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	183 E GLENARM ST
Second Line	:	SUITE 104
City	:	PASADENA
State	:	CA
Zip	:	91105-3460
Country	:	US
Telephone Number	:	626-799-4100
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. GARBIS KHANJIAN
Credential	:	D.C.
Telephone Number	:	626-799-4100

Provider Enumeration Date	:	08/30/2011
Last Update Date	:	08/30/2011

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