Provider Demographics
NPI:1205957255
Name:ROFAGHA, NAZEE (CHIROPRACTOR)
Entity type:Individual
Prefix:DR
First Name:NAZEE
Middle Name:
Last Name:ROFAGHA
Suffix:
Gender:F
Credentials:CHIROPRACTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 S CHESTER AVE # 102
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-3104
Mailing Address - Country:US
Mailing Address - Phone:626-583-9116
Mailing Address - Fax:626-583-9115
Practice Address - Street 1:99 S CHESTER AVE # 102
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-3104
Practice Address - Country:US
Practice Address - Phone:626-583-9116
Practice Address - Fax:626-583-9115
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC23582AMedicare ID - Type Unspecified