Provider Demographics
NPI:1649676123
Name:FAGHIHI, KIMIA (DC)
Entity type:Individual
Prefix:DR
First Name:KIMIA
Middle Name:
Last Name:FAGHIHI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3631 OAKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-4429
Mailing Address - Country:US
Mailing Address - Phone:818-934-5173
Mailing Address - Fax:
Practice Address - Street 1:12626 RIVERSIDE DR STE 301
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3473
Practice Address - Country:US
Practice Address - Phone:818-452-9266
Practice Address - Fax:707-873-7835
Is Sole Proprietor?:No
Enumeration Date:2014-11-11
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33112111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor