Organization
SHAHRESTANI CHIROPRACTIC PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BABAK R SHAHRESTANI DC (PRESIDENT)
(949) 631-3139
Entity
Organization
Contact information
Practice address
2328 NEWPORT BLVD, COSTA MESA, CA 92627-1548
(949) 631-3139
(949) 631-0747
Mailing address
2328 NEWPORT BLVD, COSTA MESA, CA 92627-1548
(949) 631-3139
(949) 631-0747
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
19600
CA
261QH0100X
Health Service Clinic/Center
Primary
19600
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC19600
PTAN
CA
Enumeration date
01/12/2011
Last updated
01/12/2011
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