Provider Demographics
NPI:1467653451
Name:BOGHOSSIAN & MARTIKIAN CHIROPRACTIC INC
Entity Type:Organization
Organization Name:BOGHOSSIAN & MARTIKIAN CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO DR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGHOSSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-242-5020
Mailing Address - Street 1:435 ARDEN AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-4028
Mailing Address - Country:US
Mailing Address - Phone:818-242-5020
Mailing Address - Fax:818-242-5023
Practice Address - Street 1:435 ARDEN AVE STE 120
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-4028
Practice Address - Country:US
Practice Address - Phone:818-242-5020
Practice Address - Fax:818-242-5023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26683261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center