Provider Demographics
NPI:1225656630
Name:CYRUS KHALILI CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:CYRUS KHALILI CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALILI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:562-217-9019
Mailing Address - Street 1:14034 PIONEER BLVD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3900
Mailing Address - Country:US
Mailing Address - Phone:562-217-9019
Mailing Address - Fax:562-864-6899
Practice Address - Street 1:14034 PIONEER BLVD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3900
Practice Address - Country:US
Practice Address - Phone:562-217-9019
Practice Address - Fax:562-864-6899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty