Provider Demographics
NPI:1417968397
Name:MOUSSELI, FARRAH (DC, QME)
Entity Type:Individual
Prefix:DR
First Name:FARRAH
Middle Name:
Last Name:MOUSSELI
Suffix:
Gender:F
Credentials:DC, QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 SOLAR DR
Mailing Address - Street 2:#102
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2661
Mailing Address - Country:US
Mailing Address - Phone:805-973-0919
Mailing Address - Fax:805-973-0920
Practice Address - Street 1:2100 SOLAR DR
Practice Address - Street 2:#102
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-2661
Practice Address - Country:US
Practice Address - Phone:805-973-0919
Practice Address - Fax:805-973-0920
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28403111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV06417Medicare UPIN
CAWDC28403AMedicare ID - Type Unspecified