Provider Demographics
NPI:1114006525
Name:NOURIAN, KAMBIZ (DC)
Entity Type:Individual
Prefix:DR
First Name:KAMBIZ
Middle Name:
Last Name:NOURIAN
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 1:9301 WILSHIRE BLVD STE 405A
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-6139
Mailing Address - Country:US
Mailing Address - Phone:310-274-5767
Mailing Address - Fax:310-274-5767
Practice Address - Street 1:9301 WILSHIRE BLVD STE 405A
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-6139
Practice Address - Country:US
Practice Address - Phone:310-274-5767
Practice Address - Fax:310-274-5767
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0217640Medicaid
CADC0217640Medicaid
CAU41982Medicare UPIN