Provider Demographics
NPI:1104994854
Name:BADKOUBEI, DARAB (DC)
Entity type:Individual
Prefix:DR
First Name:DARAB
Middle Name:
Last Name:BADKOUBEI
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 1:500 E. OLIVE AVE
Mailing Address - Street 2:STE 660
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-2132
Mailing Address - Country:US
Mailing Address - Phone:818-729-0300
Mailing Address - Fax:818-729-0400
Practice Address - Street 1:500 E. OLIVE AVE
Practice Address - Street 2:STE 660
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501-2132
Practice Address - Country:US
Practice Address - Phone:818-729-0300
Practice Address - Fax:818-729-0400
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor