Provider Demographics
NPI:1093991580
Name:MALEKNIAZI, JAHANGIR (LAC)
Entity Type:Individual
Prefix:DR
First Name:JAHANGIR
Middle Name:
Last Name:MALEKNIAZI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18520 SOLEDAD CANYON RD
Mailing Address - Street 2:SUITE #D
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91351-3775
Mailing Address - Country:US
Mailing Address - Phone:661-298-2420
Mailing Address - Fax:
Practice Address - Street 1:18520 SOLEDAD CANYON RD
Practice Address - Street 2:SUITE #D
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91351-3775
Practice Address - Country:US
Practice Address - Phone:661-298-2420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10955171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist