1548271372 NPI number — MOUSSELI CHIROPRACTIC CORPORATION

Table of content: (NPI 1548271372)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548271372 NPI number — MOUSSELI CHIROPRACTIC CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOUSSELI CHIROPRACTIC CORPORATION
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:
1548271372
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11022 WINNERS CIR
Provider Second Line Business Mailing Address:
SUITE 107
Provider Business Mailing Address City Name:
LOS ALAMITOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90720-2832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-973-0919
Provider Business Mailing Address Fax Number:
805-973-0920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 SOLAR DR
Provider Second Line Business Practice Location Address:
SUITE 165
Provider Business Practice Location Address City Name:
OXNARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93030-8234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-973-0919
Provider Business Practice Location Address Fax Number:
805-973-0920
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MOUSSELI
Authorized Official First Name:
FATANEH
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
805-973-0919

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com