Provider Demographics
NPI:1669643656
Name:JANFAZA CHIROPRACTIC CORPORATION
Entity Type:Organization
Organization Name:JANFAZA CHIROPRACTIC CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAHANGIR
Authorized Official - Middle Name:SANDALISSAZAN
Authorized Official - Last Name:JANFAZA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-859-8494
Mailing Address - Street 1:P.O. BOX 2578
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213
Mailing Address - Country:US
Mailing Address - Phone:310-859-8494
Mailing Address - Fax:310-859-1573
Practice Address - Street 1:9025 WILSHIRE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211
Practice Address - Country:US
Practice Address - Phone:310-859-8494
Practice Address - Fax:310-859-1573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12434111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty