Provider Demographics
NPI:1912003674
Name:PEYMANI, PARISSA (DC)
Entity Type:Individual
Prefix:
First Name:PARISSA
Middle Name:
Last Name:PEYMANI
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 1:5858 HORTON ST STE 155
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-2062
Mailing Address - Country:US
Mailing Address - Phone:510-655-5540
Mailing Address - Fax:510-655-5542
Practice Address - Street 1:5858 HORTON ST STE 155
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-2062
Practice Address - Country:US
Practice Address - Phone:510-655-5540
Practice Address - Fax:510-655-5542
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24262111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0242620Medicare PIN