Provider Demographics
NPI:1376637819
Name:TEPELEKIAN, ARA (DC)
Entity Type:Individual
Prefix:DR
First Name:ARA
Middle Name:
Last Name:TEPELEKIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18531 ROSCOE BLVD.
Mailing Address - Street 2:SUITE 215
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324
Mailing Address - Country:US
Mailing Address - Phone:818-700-0478
Mailing Address - Fax:818-975-9995
Practice Address - Street 1:18531 ROSCOE BLVD.
Practice Address - Street 2:SUITE 215
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324
Practice Address - Country:US
Practice Address - Phone:818-700-0478
Practice Address - Fax:818-975-9995
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27178OtherLICENSE NUMBER
CACB252391Medicare PIN