Provider Demographics
NPI:1134312424
Name:YAZDI, KAMBIZ (DC)
Entity Type:Individual
Prefix:DR
First Name:KAMBIZ
Middle Name:
Last Name:YAZDI
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 1:22251 PALOS VERDES BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-2016
Mailing Address - Country:US
Mailing Address - Phone:310-540-9333
Mailing Address - Fax:
Practice Address - Street 1:22251 PALOS VERDES BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2016
Practice Address - Country:US
Practice Address - Phone:310-540-9333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 30660111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor