Provider Demographics
NPI:1114036100
Name:PAVEHZADEH, HOUSHANG DANNY SR (DC BS)
Entity Type:Individual
Prefix:DR
First Name:HOUSHANG
Middle Name:DANNY
Last Name:PAVEHZADEH
Suffix:SR
Gender:M
Credentials:DC BS
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Mailing Address - Street 1:12737 GLENOAKS BLVD
Mailing Address - Street 2:SUITE #12
Mailing Address - City:SYLMAN
Mailing Address - State:CA
Mailing Address - Zip Code:91342
Mailing Address - Country:US
Mailing Address - Phone:818-367-9068
Mailing Address - Fax:818-367-9069
Practice Address - Street 1:12737 GLENOAKS BLVD
Practice Address - Street 2:SUITE #12
Practice Address - City:SYLMAN
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:818-367-9068
Practice Address - Fax:818-367-9069
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CADC29084111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V02162Medicare UPIN
CADC29084Medicare ID - Type Unspecified