Provider Demographics
NPI:1497828602
Name:KIANIAN, GUITA (DC)
Entity Type:Individual
Prefix:DR
First Name:GUITA
Middle Name:
Last Name:KIANIAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 E. SANTA CLARA ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-2014
Mailing Address - Country:US
Mailing Address - Phone:408-294-7692
Mailing Address - Fax:
Practice Address - Street 1:551 E SANTA CLARA ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-2014
Practice Address - Country:US
Practice Address - Phone:408-294-7692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22738111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0227381Medicare ID - Type Unspecified
CA460280Medicare UPIN