1497888911 NPI number — BAHAR DANESH-GHARIB CHIROPRACTIC, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497888911 NPI number — BAHAR DANESH-GHARIB CHIROPRACTIC, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BAHAR DANESH-GHARIB CHIROPRACTIC, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497888911
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
132 S VERMONT AVE
Provider Second Line Business Mailing Address:
SUITE #204
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90004-5954
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-389-2526
Provider Business Mailing Address Fax Number:
213-389-2506

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17547 VENTURA BLVD
Provider Second Line Business Practice Location Address:
SUITE # 308-A
Provider Business Practice Location Address City Name:
ENCINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91316-3853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-906-8972
Provider Business Practice Location Address Fax Number:
818-906-8947
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GHARIB
Authorized Official First Name:
BAHAR
Authorized Official Middle Name:
DANESH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
213-389-2526

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  DC28361 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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