Provider Demographics
NPI:1346271095
Name:MESHKANIAN, JACKLIN (DC)
Entity Type:Individual
Prefix:DR
First Name:JACKLIN
Middle Name:
Last Name:MESHKANIAN
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 1:6464 W SUNSET BLVD
Mailing Address - Street 2:#947
Mailing Address - City:HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90028
Mailing Address - Country:US
Mailing Address - Phone:323-466-7688
Mailing Address - Fax:323-375-0438
Practice Address - Street 1:6464 W SUNSET BLVD
Practice Address - Street 2:#947
Practice Address - City:HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90028
Practice Address - Country:US
Practice Address - Phone:323-466-7688
Practice Address - Fax:323-375-0438
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA25472111N00000X
CA25472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25472Medicare PIN
CAV03069Medicare UPIN