Provider Demographics
NPI:1538465919
Name:ILBEIG, JOUBIN (DC)
Entity Type:Individual
Prefix:MR
First Name:JOUBIN
Middle Name:
Last Name:ILBEIG
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 1:6250 CANOGA AVE APT 315
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2484
Mailing Address - Country:US
Mailing Address - Phone:818-425-4002
Mailing Address - Fax:
Practice Address - Street 1:20929 VENTURA BLVD STE 39
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-0822
Practice Address - Country:US
Practice Address - Phone:818-704-1188
Practice Address - Fax:818-704-9588
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor