MEDICARE: DR. SEVAN AMIRIAN 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	DC32333	CA

General Provider Information

NPI Number	:	1932449048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEVAN AMIRIAN D.C.

Provider Business Mailing Address
First Line	:	1108 COLORADO BLVD
Second Line	:
City	:	EAGLE ROCK
State	:	CA
Zip	:	90041-2504
Country	:	US
Telephone Number	:	818-755-9977
Fax Number	:	818-755-9917

Provider Business Practice Location Address
First Line	:	1108 COLORADO BLVD
Second Line	:
City	:	EAGLE ROCK
State	:	CA
Zip	:	90041-2504
Country	:	US
Telephone Number	:	818-755-9977
Fax Number	:	818-755-9917

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

Provider Enumeration Date	:	02/26/2013
Last Update Date	:	02/26/2013

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