Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC25120 | CA |
N | 111NS0005X | Chiropractic Sports Physician | 25120 | CA |
N | 111NX0100X | Occupational Health | 25120 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 25120 | CA |
NPI | 1376520775 |
---|---|
Provider Name | Dr. Alireza Bagherian |
First Address | San Francisco, CA 94118-1725 |
Second Address | San Francisco, CA 94118-1725 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC25120 | CHIROPRACTIC ID (01) | CA |