Provider Demographics
NPI:1447357702
Name:SADEGHI, KHASHAYAR (DC)
Entity type:Individual
Prefix:DR
First Name:KHASHAYAR
Middle Name:
Last Name:SADEGHI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3785 WILSHIRE BLVD
Mailing Address - Street 2:#400
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010
Mailing Address - Country:US
Mailing Address - Phone:213-385-4535
Mailing Address - Fax:213-385-0204
Practice Address - Street 1:#3785 WILSHIRE BOULEVARD
Practice Address - Street 2:SUITE#400
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010
Practice Address - Country:US
Practice Address - Phone:213-385-4535
Practice Address - Fax:213-385-0204
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23973111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor