Provider Demographics
NPI:1073659223
Name:JANFAZA, JAHANGIR SANDALISAZAN (DC)
Entity Type:Individual
Prefix:
First Name:JAHANGIR
Middle Name:SANDALISAZAN
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:PO BOX 2578
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213
Mailing Address - Country:US
Mailing Address - Phone:310-859-8494
Mailing Address - Fax:310-859-1573
Practice Address - Street 1:9025 WILSHIRE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1825
Practice Address - Country:US
Practice Address - Phone:310-859-8494
Practice Address - Fax:310-859-1573
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12434111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor