Provider Demographics
NPI:1295256600
Name:YUSUFBEKOV, BEHRUZ (DC)
Entity type:Individual
Prefix:DR
First Name:BEHRUZ
Middle Name:
Last Name:YUSUFBEKOV
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 1:92-1309 KUAMU ST
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-1555
Mailing Address - Country:US
Mailing Address - Phone:720-257-4242
Mailing Address - Fax:
Practice Address - Street 1:9478 W OLYMPIC BLVD
Practice Address - Street 2:PH
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212
Practice Address - Country:US
Practice Address - Phone:310-556-8071
Practice Address - Fax:310-556-3880
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-06
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34001111N00000X
COCHR.0007637111N00000X
HIDC-1413111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor