Provider Demographics
NPI:1285796888
Name:ADVANCED CHIROPRACTIC MEDICAL REHAB INC
Entity type:Organization
Organization Name:ADVANCED CHIROPRACTIC MEDICAL REHAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PARVIN
Authorized Official - Middle Name:V
Authorized Official - Last Name:ALEMI
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTOR DC
Authorized Official - Phone:818-909-0001
Mailing Address - Street 1:6470 VAN NUYS BLVD
Mailing Address - Street 2:#B
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1498
Mailing Address - Country:US
Mailing Address - Phone:818-909-0001
Mailing Address - Fax:818-787-9899
Practice Address - Street 1:6470 VAN NUYS BLVD
Practice Address - Street 2:#B
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1498
Practice Address - Country:US
Practice Address - Phone:818-909-0001
Practice Address - Fax:818-787-9899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty