Provider Demographics
NPI:1063092492
Name:ESLAMY, GHAZAL (DC)
Entity type:Individual
Prefix:DR
First Name:GHAZAL
Middle Name:
Last Name:ESLAMY
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 1:20201 SW BIRCH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1781
Mailing Address - Country:US
Mailing Address - Phone:949-259-5054
Mailing Address - Fax:
Practice Address - Street 1:20201 SW BIRCH ST STE 100
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1781
Practice Address - Country:US
Practice Address - Phone:949-259-5054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor