Provider Demographics
NPI:1164690038
Name:NOSTATI, ORIT (DC)
Entity Type:Individual
Prefix:
First Name:ORIT
Middle Name:
Last Name:NOSTATI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16444 PARAMOUNT BLVD
Mailing Address - Street 2:101
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-5422
Mailing Address - Country:US
Mailing Address - Phone:562-630-1220
Mailing Address - Fax:562-630-0701
Practice Address - Street 1:16444 PARAMOUNT BLVD
Practice Address - Street 2:101
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-5422
Practice Address - Country:US
Practice Address - Phone:562-630-1220
Practice Address - Fax:562-630-0701
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29432111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC29432OtherLICENSE #