Provider Demographics
NPI:1780826008
Name:ROYA KAZEMI CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:ROYA KAZEMI CHIROPRACTIC, INC.
Other - Org Name:SMART CARE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROYA
Authorized Official - Middle Name:E
Authorized Official - Last Name:KAZEMI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-888-5540
Mailing Address - Street 1:22119 SHERMAN WAY
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1137
Mailing Address - Country:US
Mailing Address - Phone:818-888-5540
Mailing Address - Fax:818-888-5704
Practice Address - Street 1:22119 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1137
Practice Address - Country:US
Practice Address - Phone:818-888-5540
Practice Address - Fax:818-888-5704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27991111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty