Provider Demographics
NPI:1629657051
Name:CALIFORNIA CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:CALIFORNIA CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OMER
Authorized Official - Middle Name:SAHAN
Authorized Official - Last Name:BOYSAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-335-1537
Mailing Address - Street 1:21049 DEVONSHIRE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-2375
Mailing Address - Country:US
Mailing Address - Phone:818-335-1537
Mailing Address - Fax:818-550-6694
Practice Address - Street 1:21049 DEVONSHIRE ST STE 102
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2375
Practice Address - Country:US
Practice Address - Phone:818-335-1537
Practice Address - Fax:818-550-6694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-04
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12355706OtherCAQH
CAOB1140055OtherASHLINK ID