Provider Demographics
NPI:1386713295
Name:GHIAI, MARJANEH (DC QME)
Entity type:Individual
Prefix:DR
First Name:MARJANEH
Middle Name:
Last Name:GHIAI
Suffix:
Gender:F
Credentials:DC QME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17075 DEVONSHIRE ST STE 302
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-5412
Mailing Address - Country:US
Mailing Address - Phone:818-606-3960
Mailing Address - Fax:818-368-9173
Practice Address - Street 1:17075 DEVONSHIRE ST STE 302
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-5412
Practice Address - Country:US
Practice Address - Phone:818-606-3960
Practice Address - Fax:818-368-9173
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24923111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor