MEDICARE: DR. KIMIA FAGHIHI D.C.

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	33112	CA

General Provider Information

NPI Number	:	1649676123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMIA FAGHIHI D.C.

Provider Business Mailing Address
First Line	:	3631 OAKFIELD DR
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91423-4429
Country	:	US
Telephone Number	:	818-934-5173
Fax Number	:

Provider Business Practice Location Address
First Line	:	12626 RIVERSIDE DR STE 301
Second Line	:
City	:	VALLEY VILLAGE
State	:	CA
Zip	:	91607-3473
Country	:	US
Telephone Number	:	818-452-9266
Fax Number	:	707-873-7835

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

Provider Enumeration Date	:	11/11/2014
Last Update Date	:	05/16/2024

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