Provider Demographics
NPI:1134232499
Name:RAHMANIAN, OMID (DC)
Entity type:Individual
Prefix:DR
First Name:OMID
Middle Name:
Last Name:RAHMANIAN
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 1:9001 JEWEL LAKE RD
Mailing Address - Street 2:STE 3
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-5354
Mailing Address - Country:US
Mailing Address - Phone:907-529-0247
Mailing Address - Fax:907-771-9744
Practice Address - Street 1:9001 JEWEL LAKE RD
Practice Address - Street 2:STE 3
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-5354
Practice Address - Country:US
Practice Address - Phone:907-529-0247
Practice Address - Fax:907-771-9744
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK521111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK521OtherSTATE OF ALASKA LICENSE