Provider Demographics
NPI:1942347869
Name:MOHSEN ALIREZAI CHIROPRACTIC CORP
Entity Type:Organization
Organization Name:MOHSEN ALIREZAI CHIROPRACTIC CORP
Other - Org Name:ABSOLUTE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIREZAI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-371-5610
Mailing Address - Street 1:166 N MOORPARK RD STE 301
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4437
Mailing Address - Country:US
Mailing Address - Phone:805-371-5610
Mailing Address - Fax:805-371-5611
Practice Address - Street 1:166 N MOORPARK RD STE 301
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4437
Practice Address - Country:US
Practice Address - Phone:805-371-5610
Practice Address - Fax:805-371-5611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29864111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV09931Medicare UPIN