Provider Demographics
NPI:1740316082
Name:KAZANDJIAN CHIROPRACTIC HEALTH CENTER INC.
Entity type:Organization
Organization Name:KAZANDJIAN CHIROPRACTIC HEALTH CENTER INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TSOLAG
Authorized Official - Middle Name:JIMMY
Authorized Official - Last Name:KAZANDJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:818-500-9291
Mailing Address - Street 1:265 E ORANGE GROVE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-1229
Mailing Address - Country:US
Mailing Address - Phone:818-500-9291
Mailing Address - Fax:818-660-2590
Practice Address - Street 1:265 E ORANGE GROVE AVE STE B
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502
Practice Address - Country:US
Practice Address - Phone:818-500-9291
Practice Address - Fax:818-660-2590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30283111N00000X
CAAC12433171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20486OtherGROUP MEDICARE IDENTIFICATION NUMBER