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NPI Code Detail

MEDICARE: DR. REZA ROSHAN PAJOUH DOCTOR OF CHIROPRACT

MEDICARE: DR. REZA ROSHAN PAJOUH DOCTOR OF CHIROPRACT
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
1111N00000XChiropractor36852CA

General Provider Information

NPI Number : 1760247837
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REZA ROSHAN PAJOUH DOCTOR OF CHIROPRACT
Provider Business Mailing Address
First Line : 4675 STEVENS CREEK BLVD STE 121
Second Line :
City : SANTA CLARA
State : CA
Zip : 95051-6763
Country : US
Telephone Number : 949-619-0287
Fax Number : 408-394-0288
Provider Business Practice Location Address
First Line : 4675 STEVENS CREEK BLVD STE 121
Second Line :
City : SANTA CLARA
State : CA
Zip : 95051-6763
Country : US
Telephone Number : 408-394-0288
Fax Number : 408-216-9030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2024
Last Update Date : 02/19/2024

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