Provider Demographics
NPI:1740354661
Name:GHASSEMI, ROMINA (DC)
Entity type:Individual
Prefix:DR
First Name:ROMINA
Middle Name:
Last Name:GHASSEMI
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 1:155 W WASHINGTON BLVD STE 516
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3582
Mailing Address - Country:US
Mailing Address - Phone:424-379-9357
Mailing Address - Fax:
Practice Address - Street 1:155 W WASHINGTON BLVD STE 516
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3582
Practice Address - Country:US
Practice Address - Phone:424-379-9357
Practice Address - Fax:310-548-5242
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23816111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC23816Medicare PIN