Provider Demographics
NPI:1497888911
Name:BAHAR DANESH-GHARIB CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:BAHAR DANESH-GHARIB CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAHAR
Authorized Official - Middle Name:DANESH
Authorized Official - Last Name:GHARIB
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:213-389-2526
Mailing Address - Street 1:132 S VERMONT AVE
Mailing Address - Street 2:SUITE #204
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-5954
Mailing Address - Country:US
Mailing Address - Phone:213-389-2526
Mailing Address - Fax:213-389-2506
Practice Address - Street 1:17547 VENTURA BLVD
Practice Address - Street 2:SUITE # 308-A
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3853
Practice Address - Country:US
Practice Address - Phone:818-906-8972
Practice Address - Fax:818-906-8947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty