Provider Demographics
NPI:1891197034
Name:KUPELIAN CHIROPRACTIC HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:KUPELIAN CHIROPRACTIC HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ASDGHIK
Authorized Official - Middle Name:STAR
Authorized Official - Last Name:KUPELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:1818-484-8901
Mailing Address - Street 1:1332 S GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-3349
Mailing Address - Country:US
Mailing Address - Phone:818-484-8901
Mailing Address - Fax:818-484-8902
Practice Address - Street 1:1332 S GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-3349
Practice Address - Country:US
Practice Address - Phone:818-484-8901
Practice Address - Fax:818-484-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32680111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty