Provider Demographics
NPI:1336474733
Name:HAMIDI, HOMAYOUN DAVID (DC)
Entity Type:Individual
Prefix:
First Name:HOMAYOUN
Middle Name:DAVID
Last Name:HAMIDI
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 1:200 N HARBOR BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-2510
Mailing Address - Country:US
Mailing Address - Phone:714-778-0233
Mailing Address - Fax:714-778-1318
Practice Address - Street 1:200 N HARBOR BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-2510
Practice Address - Country:US
Practice Address - Phone:714-778-0233
Practice Address - Fax:714-778-1318
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21855111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor