Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NS0005X | Chiropractic Sports Physician | 25185 | CA |
N | 111NX0100X | Occupational Health | 25185 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 25185 | CA |
NPI | 1396890430 |
---|---|
Provider Name | Ms. Roya Tabibian |
First Address | Los Angeles, CA 90024-5632 |
Second Address | Los Angeles, CA 90024-5632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 08/07/2007 |