MEDICARE: MRS. MAHTAB Z NEJAD DC

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	DC25953	CA

General Provider Information

NPI Number	:	1144214800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MAHTAB Z NEJAD DC

Provider Business Mailing Address
First Line	:	1 CHARLES ST
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95032-5471
Country	:	US
Telephone Number	:	408-866-5120
Fax Number	:	408-866-5005

Provider Business Practice Location Address
First Line	:	1848 SARATOGA AVE
Second Line	:	BLD #1 SUITE #2
City	:	SARATOGA
State	:	CA
Zip	:	95070-6612
Country	:	US
Telephone Number	:	408-866-5120
Fax Number	:	408-866-5005

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	07/08/2007

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