Provider Demographics
NPI:1285818138
Name:GREGORIAN, MELINEH MELANIE (DC)
Entity Type:Individual
Prefix:
First Name:MELINEH
Middle Name:MELANIE
Last Name:GREGORIAN
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 1:540 N JACKSON ST APT 104
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-3209
Mailing Address - Country:US
Mailing Address - Phone:818-913-1798
Mailing Address - Fax:818-824-6568
Practice Address - Street 1:1100 E BROADWAY STE 203
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205
Practice Address - Country:US
Practice Address - Phone:818-334-8600
Practice Address - Fax:818-824-6568
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30691111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor