Provider Demographics
NPI:1396291738
Name:SOLEIMANI CHIROPRACTIC P C
Entity type:Organization
Organization Name:SOLEIMANI CHIROPRACTIC P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLEIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-280-0201
Mailing Address - Street 1:9040 FRIARS RD STE 401
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-5859
Mailing Address - Country:US
Mailing Address - Phone:619-280-0201
Mailing Address - Fax:619-280-0801
Practice Address - Street 1:7540 METROPOLITAN DR STE 108
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4416
Practice Address - Country:US
Practice Address - Phone:619-280-0201
Practice Address - Fax:619-280-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-26
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X
CAAC12182171100000X
CA32288111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGW975AOtherMEDICARE PTAN