Organization
SPORTS REHAB LA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK KHAZIRAN D.C. (PRESIDENT)
(818) 986-1203
Entity
Organization
Contact information
Practice address
16200 VENTURA BLVD, #201, ENCINO, CA 91436-2205
(818) 986-1203
(951) 272-9924
Mailing address
16200 VENTURA BLVD, #201, ENCINO, CA 91436-2205
(818) 986-1203
(951) 272-9924
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
—
CA
111NR0200X
Radiology Chiropractor
—
CA
111NR0400X
Rehabilitation Chiropractor
—
CA
111NS0005X
Sports Physician Chiropractor
—
CA
171100000X
Acupuncturist
—
CA
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
05/05/2017
Last updated
08/11/2017
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