MEDICARE: DR. MAZIYAR MOHSENPOUR 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	37581	CA

General Provider Information

NPI Number	:	1598502437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAZIYAR MOHSENPOUR DC

Provider Business Mailing Address
First Line	:	308 W CHAPMAN AVE
Second Line	:	#143
City	:	ORANGE
State	:	CA
Zip	:	92856
Country	:	US
Telephone Number	:	424-371-3077
Fax Number	:	424-371-3077

Provider Business Practice Location Address
First Line	:	6742 VAN NUYS BLVD STE 102
Second Line	:
City	:	VAN NUYS
State	:	CA
Zip	:	91405-4611
Country	:	US
Telephone Number	:	747-717-0034
Fax Number	:

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

Provider Enumeration Date	:	07/09/2024
Last Update Date	:	04/20/2026

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