Provider Demographics
NPI:1376520775
Name:BAGHERIAN, ALIREZA (DC)
Entity type:Individual
Prefix:DR
First Name:ALIREZA
Middle Name:
Last Name:BAGHERIAN
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 1:3580 CALIFORNIA ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1725
Mailing Address - Country:US
Mailing Address - Phone:415-921-6200
Mailing Address - Fax:415-921-6209
Practice Address - Street 1:3580 CALIFORNIA ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1725
Practice Address - Country:US
Practice Address - Phone:415-921-6200
Practice Address - Fax:415-921-6209
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-27
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25120111N00000X
CA25120111NS0005X, 111NX0100X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
No111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25120OtherCHIROPRACTIC ID
CAZZZ31125ZMedicare ID - Type UnspecifiedMEDICARE ID