Provider Demographics
NPI:1679616312
Name:JAHANIAN, DALIA (DC)
Entity Type:Individual
Prefix:
First Name:DALIA
Middle Name:
Last Name:JAHANIAN
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 1:140 S CLARK DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2604
Mailing Address - Country:US
Mailing Address - Phone:310-266-0341
Mailing Address - Fax:909-941-7866
Practice Address - Street 1:1700 WESTWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-5608
Practice Address - Country:US
Practice Address - Phone:310-266-0341
Practice Address - Fax:909-941-7866
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25717111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25717Medicare ID - Type Unspecified