Provider Demographics
NPI:1447522784
Name:REZA M. MOAREFI CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:REZA M. MOAREFI CHIROPRACTIC CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:REZA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOAREFI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-891-4000
Mailing Address - Street 1:14500 ROSCOE BLVD.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402
Mailing Address - Country:US
Mailing Address - Phone:818-891-4000
Mailing Address - Fax:818-891-4003
Practice Address - Street 1:14500 ROSCOE BLVD.
Practice Address - Street 2:SUITE 201
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402
Practice Address - Country:US
Practice Address - Phone:818-891-4000
Practice Address - Fax:818-891-4003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty