Provider Demographics
NPI:1871739953
Name:JANFAZA, RAYMOND JAMES (DC)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:JAMES
Last Name:JANFAZA
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 1:11847 WILSHIRE BL.
Mailing Address - Street 2:STE. 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:310-477-1443
Mailing Address - Fax:310-268-1222
Practice Address - Street 1:11847 WILSHIRE BL.
Practice Address - Street 2:STE. 301
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-477-1443
Practice Address - Fax:310-477-1443
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15252111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist