Provider Demographics
NPI:1801976808
Name:MEHRABANI, NEDA (DC/LAC)
Entity type:Individual
Prefix:DR
First Name:NEDA
Middle Name:
Last Name:MEHRABANI
Suffix:
Gender:F
Credentials:DC/LAC
Other - Prefix:DR
Other - First Name:NEDA
Other - Middle Name:
Other - Last Name:MEHRABANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5543 SYLVIA AVE
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3119
Mailing Address - Country:US
Mailing Address - Phone:818-990-5321
Mailing Address - Fax:818-990-6953
Practice Address - Street 1:17337 VENTURA BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3903
Practice Address - Country:US
Practice Address - Phone:818-990-5321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25902111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor