Provider Demographics
NPI:1902263627
Name:NOWZARINEZHAD, BIJAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BIJAN
Middle Name:
Last Name:NOWZARINEZHAD
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 1:3051 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3425
Mailing Address - Country:US
Mailing Address - Phone:818-472-6747
Mailing Address - Fax:
Practice Address - Street 1:716 S VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2425
Practice Address - Country:US
Practice Address - Phone:818-275-4822
Practice Address - Fax:818-843-3610
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-26
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC33413111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor