Provider Demographics
NPI:1598097271
Name:NOURMAND, FARNAZ ESTHER (DC)
Entity Type:Individual
Prefix:DR
First Name:FARNAZ
Middle Name:ESTHER
Last Name:NOURMAND
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 1:8615 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2301
Mailing Address - Country:US
Mailing Address - Phone:310-289-1970
Mailing Address - Fax:310-289-8960
Practice Address - Street 1:8615 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2301
Practice Address - Country:US
Practice Address - Phone:310-289-1970
Practice Address - Fax:310-289-8960
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU52868Medicare UPIN