Provider Demographics
NPI:1629285028
Name:BASSIRI, RAMESH U (DC)
Entity Type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:U
Last Name:BASSIRI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4444 W RIVERSIDE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4073
Mailing Address - Country:US
Mailing Address - Phone:818-567-2277
Mailing Address - Fax:818-845-8543
Practice Address - Street 1:4444 W RIVERSIDE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4073
Practice Address - Country:US
Practice Address - Phone:818-567-2277
Practice Address - Fax:818-845-8543
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21230111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2130OtherSTATE LICENSE
CACH689ZMedicare PIN
CA2130OtherSTATE LICENSE