Provider Demographics
NPI:1720399827
Name:TEPELEKIAN CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:TEPELEKIAN CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEPELEKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-700-0478
Mailing Address - Street 1:18531 ROSCOE BLVD
Mailing Address - Street 2:215
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4641
Mailing Address - Country:US
Mailing Address - Phone:818-700-0478
Mailing Address - Fax:
Practice Address - Street 1:18531 ROSCOE BLVD
Practice Address - Street 2:215
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4641
Practice Address - Country:US
Practice Address - Phone:818-700-0478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27178111N00000X
208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
BS376AMedicare PIN