Provider Demographics
NPI:1225594633
Name:MOUSAVI, AZIEN (DC)
Entity Type:Individual
Prefix:
First Name:AZIEN
Middle Name:
Last Name:MOUSAVI
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 1:1901 E 1ST ST APT 363
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4090
Mailing Address - Country:US
Mailing Address - Phone:415-828-9858
Mailing Address - Fax:714-888-4510
Practice Address - Street 1:2010 E 1ST ST STE 270
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4083
Practice Address - Country:US
Practice Address - Phone:657-221-5436
Practice Address - Fax:714-888-4510
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13937111N00000X
CA34399111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor