Provider Demographics
NPI:1659457034
Name:CHALIKIAN, ALICE BEATRICE (DC)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:BEATRICE
Last Name:CHALIKIAN
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 1:221 E WALNUT ST
Mailing Address - Street 2:SUITE 275
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1585
Mailing Address - Country:US
Mailing Address - Phone:626-765-0555
Mailing Address - Fax:626-765-0248
Practice Address - Street 1:221 E WALNUT ST
Practice Address - Street 2:SUITE 275
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1585
Practice Address - Country:US
Practice Address - Phone:626-765-0555
Practice Address - Fax:626-765-0248
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28350111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC28350Medicare PIN