MEDICARE: DR. AFSOUN NADERI 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	23330	CA

General Provider Information

NPI Number	:	1568212207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AFSOUN NADERI DC

Provider Business Mailing Address
First Line	:	10 VIA AMBRA
Second Line	:
City	:	NEWPORT COAST
State	:	CA
Zip	:	92657-1610
Country	:	US
Telephone Number	:	714-501-2724
Fax Number	:

Provider Business Practice Location Address
First Line	:	6850 BROCKTON AVE STE 104
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-3814
Country	:	US
Telephone Number	:	951-444-5090
Fax Number	:

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

Provider Enumeration Date	:	03/25/2024
Last Update Date	:	03/25/2024

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Directions to “ DR. AFSOUN NADERI DC” Practice Location

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