Provider Demographics
NPI:1770301293
Name:ROSTAMI, ARMEN (DC)
Entity type:Individual
Prefix:DR
First Name:ARMEN
Middle Name:
Last Name:ROSTAMI
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 1:3702 PARK PL
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1623
Mailing Address - Country:US
Mailing Address - Phone:818-512-4412
Mailing Address - Fax:
Practice Address - Street 1:3702 PARK PL
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1623
Practice Address - Country:US
Practice Address - Phone:818-512-4412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36767111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor