Provider Demographics
NPI:1437257516
Name:YEGHYAYAN, VAHE (DC)
Entity Type:Individual
Prefix:DR
First Name:VAHE
Middle Name:
Last Name:YEGHYAYAN
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 1:18906 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3212
Mailing Address - Country:US
Mailing Address - Phone:818-774-1620
Mailing Address - Fax:818-774-1615
Practice Address - Street 1:18906 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3212
Practice Address - Country:US
Practice Address - Phone:818-774-1620
Practice Address - Fax:818-774-1615
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26597111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU89075Medicare UPIN