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NPI Code Detail

MEDICARE: DR. PAYAM YERMIAN D.C.

MEDICARE: DR. PAYAM YERMIAN 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
1111N00000XChiropractorDC-28201CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DC0282010OTHERCABLUE SHIELD OF CA

General Provider Information

NPI Number : 1710001722
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAYAM YERMIAN D.C.
Provider Business Mailing Address
First Line : 3200 SANTA MONICA BLVD
Second Line : SUITE 101
City : SANTA MONICA
State : CA
Zip : 90404-2637
Country : US
Telephone Number : 310-828-8808
Fax Number : 310-828-8919
Provider Business Practice Location Address
First Line : 3200 SANTA MONICA BLVD
Second Line : SUITE 101
City : SANTA MONICA
State : CA
Zip : 90404-2637
Country : US
Telephone Number : 310-828-8808
Fax Number : 310-828-8919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 07/09/2007

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