Provider Demographics
NPI:1033343264
Name:MEHRABIAN, SARKIS S (DC)
Entity Type:Individual
Prefix:
First Name:SARKIS
Middle Name:S
Last Name:MEHRABIAN
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 1:3742 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91214-1740
Mailing Address - Country:US
Mailing Address - Phone:818-248-9200
Mailing Address - Fax:
Practice Address - Street 1:3742 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91214-1740
Practice Address - Country:US
Practice Address - Phone:818-248-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC31046OtherCHIROPRACTIC LICENSE