Provider Demographics
NPI:1518103845
Name:A-CHIROCARE
Entity Type:Organization
Organization Name:A-CHIROCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARANAK
Authorized Official - Middle Name:
Authorized Official - Last Name:DEHGHAN-ABNAVI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-360-9517
Mailing Address - Street 1:8923 DE SOTO AVE
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-1966
Mailing Address - Country:US
Mailing Address - Phone:818-576-0901
Mailing Address - Fax:818-576-0902
Practice Address - Street 1:8923 DE SOTO AVE
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-1966
Practice Address - Country:US
Practice Address - Phone:818-576-0901
Practice Address - Fax:818-576-0902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24882302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1083719132OtherNPI NUMBER