Provider Demographics
NPI:1104074087
Name:CHALIKIAN CHIROPRACTIC CORPORATION
Entity type:Organization
Organization Name:CHALIKIAN CHIROPRACTIC CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, DC
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALIKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:626-765-0555
Mailing Address - Street 1:221 E WALNUT ST STE 275
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-6001
Mailing Address - Country:US
Mailing Address - Phone:626-765-0555
Mailing Address - Fax:626-765-0248
Practice Address - Street 1:221 E WALNUT ST STE 275
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-6001
Practice Address - Country:US
Practice Address - Phone:626-765-0555
Practice Address - Fax:626-765-0248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28350111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1659457034OtherNPI
CADC28350Medicare PIN