Provider Demographics
NPI:1578004503
Name:DAVID MASHADIAN CHIROPRACTIC DC INC
Entity Type:Organization
Organization Name:DAVID MASHADIAN CHIROPRACTIC DC INC
Other - Org Name:ELITE PAIN CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MASHADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-560-0227
Mailing Address - Street 1:14401 SYLVAN ST #101
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401
Mailing Address - Country:US
Mailing Address - Phone:424-281-9391
Mailing Address - Fax:
Practice Address - Street 1:14401 SYLVAN ST #101
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401
Practice Address - Country:US
Practice Address - Phone:424-281-9391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty