Provider Demographics
NPI:1942479472
Name:POURARBAB, PEJMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:PEJMAN
Middle Name:
Last Name:POURARBAB
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 1:4151 N. 32ND ST.
Mailing Address - Street 2:#B
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018
Mailing Address - Country:US
Mailing Address - Phone:602-522-2273
Mailing Address - Fax:602-553-2272
Practice Address - Street 1:4151 N 32ND ST
Practice Address - Street 2:#B
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-4701
Practice Address - Country:US
Practice Address - Phone:602-522-2273
Practice Address - Fax:602-553-2272
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7052111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation