Individual
DR. BABAK ROBERT SHAHRESTANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
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
111N00000X
Chiropractor
Primary
19600
CA
111NS0005X
Sports Physician Chiropractor
DC19600
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33-0479857
OLD CORPORATE NUMBER
CA
01
—
33-0793733
CORPORATE NUMBER
CA
Enumeration date
02/09/2007
Last updated
12/20/2016
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