Provider Demographics
NPI:1497797823
Name:ALIREZAI, MOHSEN (DC)
Entity Type:Individual
Prefix:DR
First Name:MOHSEN
Middle Name:
Last Name:ALIREZAI
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:PO BOX 570203
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91357-0203
Mailing Address - Country:US
Mailing Address - Phone:805-371-5610
Mailing Address - Fax:805-371-5611
Practice Address - Street 1:166 N MOORPARK RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4437
Practice Address - Country:US
Practice Address - Phone:805-371-5610
Practice Address - Fax:805-371-5611
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29864111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor