Provider Demographics
NPI:1023239415
Name:KARIMIANPOUR, MEHRDAD (DC)
Entity type:Individual
Prefix:DR
First Name:MEHRDAD
Middle Name:
Last Name:KARIMIANPOUR
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 1:12531 HARBOR BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-5824
Mailing Address - Country:US
Mailing Address - Phone:714-534-9111
Mailing Address - Fax:714-534-3006
Practice Address - Street 1:12531 HARBOR BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-5824
Practice Address - Country:US
Practice Address - Phone:714-534-9111
Practice Address - Fax:714-534-3006
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 26881111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor