Provider Demographics
NPI:1386991396
Name:JAHANGIRI, KYLE KAMRAN (DC)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:KAMRAN
Last Name:JAHANGIRI
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 1:32663 KENITA WAY
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-3001
Mailing Address - Country:US
Mailing Address - Phone:510-415-9175
Mailing Address - Fax:
Practice Address - Street 1:32663 KENITA WAY
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-3001
Practice Address - Country:US
Practice Address - Phone:510-415-9175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32362111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology