MEDICARE: DR. BANAFSHEH BEHESHTI 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	34995	CA

General Provider Information

NPI Number	:	1851981716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BANAFSHEH BEHESHTI DC

Provider Business Mailing Address
First Line	:	5807 TOPANGA CANYON BLVD APT L207
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-4648
Country	:	US
Telephone Number	:	818-857-0856
Fax Number	:

Provider Business Practice Location Address
First Line	:	5807 TOPANGA CANYON BLVD APT L207
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-4648
Country	:	US
Telephone Number	:	818-857-0856
Fax Number	:

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

Provider Enumeration Date	:	01/24/2021
Last Update Date	:	01/24/2021

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