Provider Demographics
NPI:1598823197
Name:YAGHJIAN CHIROPRACTIC A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:YAGHJIAN CHIROPRACTIC A PROFESSIONAL CORPORATION
Other - Org Name:YAGHJIAN CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARA
Authorized Official - Middle Name:V
Authorized Official - Last Name:YAGHJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-798-8951
Mailing Address - Street 1:2595 E WASHINGTON BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-1409
Mailing Address - Country:US
Mailing Address - Phone:626-798-8951
Mailing Address - Fax:626-798-7458
Practice Address - Street 1:2595 E WASHINGTON BLVD STE 103
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-1409
Practice Address - Country:US
Practice Address - Phone:626-798-8951
Practice Address - Fax:626-798-7458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14289111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC14289Medicare PIN