Provider Demographics
NPI:1346384914
Name:SABETI-KOLAHI, FARANGIS (DC)
Entity Type:Individual
Prefix:MS
First Name:FARANGIS
Middle Name:
Last Name:SABETI-KOLAHI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:FARA
Other - Middle Name:
Other - Last Name:SABETI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 1377
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92609-1377
Mailing Address - Country:US
Mailing Address - Phone:714-835-1779
Mailing Address - Fax:949-680-3378
Practice Address - Street 1:24551 RAYMOND WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4400
Practice Address - Country:US
Practice Address - Phone:949-680-3377
Practice Address - Fax:949-680-3378
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U90568Medicare UPIN
CADC28161Medicare ID - Type Unspecified