Provider Demographics
NPI:1093267320
Name:NIKTA CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:NIKTA CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NIKTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDALIB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-266-1611
Mailing Address - Street 1:1020 E PALMDALE BLVD
Mailing Address - Street 2:SUITE 101C
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4756
Mailing Address - Country:US
Mailing Address - Phone:661-266-1611
Mailing Address - Fax:661-266-1295
Practice Address - Street 1:1020 E PALMDALE BLVD
Practice Address - Street 2:SUITE 101C
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4756
Practice Address - Country:US
Practice Address - Phone:661-266-1611
Practice Address - Fax:661-266-1295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23730261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center