Provider Demographics
NPI:1831442904
Name:GORGY, NIVEEN ADLI (DC)
Entity type:Individual
Prefix:DR
First Name:NIVEEN
Middle Name:ADLI
Last Name:GORGY
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 1:5173 OVERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4913
Mailing Address - Country:US
Mailing Address - Phone:310-202-0077
Mailing Address - Fax:310-202-0078
Practice Address - Street 1:5173 OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4913
Practice Address - Country:US
Practice Address - Phone:310-202-0077
Practice Address - Fax:310-202-0078
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 26057111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor