Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC-24515 | CA |
N | 111NI0013X | Independent Medical Examiner | DC-24515 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | DC-24515 | CA |
NPI | 1033321641 |
---|---|
Provider Name | Farivar Mobin |
First Address | Beverly Hills, CA 90211-5403 |
Second Address | Beverly Hills, CA 90211-5403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 08/07/2007 |