Provider Demographics
NPI:1093089138
Name:BOYSAN, OMER SAHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:OMER
Middle Name:SAHAN
Last Name:BOYSAN
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 1:21049 DEVONSHIRE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2375
Mailing Address - Country:US
Mailing Address - Phone:818-335-1537
Mailing Address - Fax:818-550-6694
Practice Address - Street 1:21049 DEVONSHIRE ST STE 102
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2375
Practice Address - Country:US
Practice Address - Phone:818-686-5983
Practice Address - Fax:818-550-6694
Is Sole Proprietor?:No
Enumeration Date:2012-03-07
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32238111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOB1140055OtherASHLINK ID
CA12355706OtherCAQH