Provider Demographics
NPI:1104097179
Name:YARMAND, ARIA (DC)
Entity type:Individual
Prefix:DR
First Name:ARIA
Middle Name:
Last Name:YARMAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13400 WASHINGTON BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5656
Mailing Address - Country:US
Mailing Address - Phone:310-622-4513
Mailing Address - Fax:310-578-9288
Practice Address - Street 1:13400 WASHINGTON BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5656
Practice Address - Country:US
Practice Address - Phone:310-622-4513
Practice Address - Fax:310-578-9288
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAV04161Medicare UPIN
CAW18543Medicare PIN