Provider Demographics
NPI:1831226703
Name:BARAHEMI, MANSOUREH (CHIROPRACTOR)
Entity type:Individual
Prefix:DR
First Name:MANSOUREH
Middle Name:
Last Name:BARAHEMI
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2208
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92859-0208
Mailing Address - Country:US
Mailing Address - Phone:714-542-1311
Mailing Address - Fax:714-543-1311
Practice Address - Street 1:1100 W TOWN AND COUNTRY RD
Practice Address - Street 2:50
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4600
Practice Address - Country:US
Practice Address - Phone:714-542-1311
Practice Address - Fax:714-543-1311
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24080111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor