Provider Demographics
NPI:1922579523
Name:ISKANDER, MINA (DC)
Entity Type:Individual
Prefix:DR
First Name:MINA
Middle Name:
Last Name:ISKANDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 WILSHIRE BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4749
Mailing Address - Country:US
Mailing Address - Phone:310-829-7339
Mailing Address - Fax:310-829-1991
Practice Address - Street 1:2730 WILSHIRE BLVD STE 230
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4749
Practice Address - Country:US
Practice Address - Phone:310-829-7339
Practice Address - Fax:310-829-1991
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-08
Last Update Date:2018-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty