Provider Demographics
NPI:1942334321
Name:MOHAMMADKHANI, ALIREZA DARIUSH (DC)
Entity Type:Individual
Prefix:DR
First Name:ALIREZA
Middle Name:DARIUSH
Last Name:MOHAMMADKHANI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:17075 DEVONSHIRE ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1600
Mailing Address - Country:US
Mailing Address - Phone:818-368-9191
Mailing Address - Fax:818-368-9173
Practice Address - Street 1:17075 DEVONSHIRE ST
Practice Address - Street 2:SUITE 302
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1600
Practice Address - Country:US
Practice Address - Phone:818-368-9191
Practice Address - Fax:818-368-9173
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CADC22939111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor