Provider Demographics
NPI:1427151919
Name:PAZDEL, BEJAN A (DC)
Entity type:Individual
Prefix:MR
First Name:BEJAN
Middle Name:A
Last Name:PAZDEL
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 1:258I SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:SUISUN
Mailing Address - State:CA
Mailing Address - Zip Code:94585
Mailing Address - Country:US
Mailing Address - Phone:707-429-4861
Mailing Address - Fax:707-429-3871
Practice Address - Street 1:258I SUNSET AVE
Practice Address - Street 2:
Practice Address - City:SUISUN
Practice Address - State:CA
Practice Address - Zip Code:94585
Practice Address - Country:US
Practice Address - Phone:707-429-4861
Practice Address - Fax:707-429-3871
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21467111N00000X
AZ4981111N00000X
ID624111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0214670Medicare ID - Type UnspecifiedMEDICARE