Provider Demographics
NPI:1942852520
Name:VAZIN CHIROPRACTIC
Entity Type:Organization
Organization Name:VAZIN CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VAZIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-519-8877
Mailing Address - Street 1:28827 LEAH CIR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-4767
Mailing Address - Country:US
Mailing Address - Phone:310-519-8877
Mailing Address - Fax:
Practice Address - Street 1:29050 S WESTERN AVE STE 152
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-0812
Practice Address - Country:US
Practice Address - Phone:310-519-8877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty