Provider Demographics
NPI:1023503679
Name:NATURE HEALTH CHIRO INC
Entity type:Organization
Organization Name:NATURE HEALTH CHIRO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GHAZALEH
Authorized Official - Middle Name:MONICA
Authorized Official - Last Name:MAHMOUDI
Authorized Official - Suffix:
Authorized Official - Credentials:DC LAC
Authorized Official - Phone:310-519-8877
Mailing Address - Street 1:PO BOX 53486
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92619-3486
Mailing Address - Country:US
Mailing Address - Phone:310-519-8877
Mailing Address - Fax:310-519-8290
Practice Address - Street 1:29050 S WESTERN AVE STE 152
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275
Practice Address - Country:US
Practice Address - Phone:310-519-8877
Practice Address - Fax:310-519-8290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-26
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18047171100000X
CA33876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty