Provider Demographics
NPI:1215074851
Name:ADJUDANI, KAMBIZ (DC)
Entity type:Individual
Prefix:DR
First Name:KAMBIZ
Middle Name:
Last Name:ADJUDANI
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 1:15095 N THOMPSON PEAK PKWY APT 2077
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2070
Mailing Address - Country:US
Mailing Address - Phone:480-831-8175
Mailing Address - Fax:480-831-8419
Practice Address - Street 1:15095 N THOMSON PEAK PKWY
Practice Address - Street 2:#2077
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-831-8175
Practice Address - Fax:480-831-8419
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor