Provider Demographics
NPI:1891980371
Name:MIRZAKHANIAN, HARMA (DC)
Entity type:Individual
Prefix:DR
First Name:HARMA
Middle Name:
Last Name:MIRZAKHANIAN
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 1:1412 W GLENOAKS BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201-1980
Mailing Address - Country:US
Mailing Address - Phone:818-241-0101
Mailing Address - Fax:
Practice Address - Street 1:1412 W GLENOAKS BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91201-1980
Practice Address - Country:US
Practice Address - Phone:818-241-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30693111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor