Active NPI
Marjan Razi Pourdavood, D.C., QME
- Orthopedic Chiropractor
- Glendale, CA
National Provider Identifier
1588911150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Chiropractor
- License
- DC 25093
- Practice address
- 610 North Central Ave
Suite 202
Glendale, CA 91203 - Phone
- (818) 244-6792
- Fax
- (818) 244-7477
- NPI assigned
- Aug 13, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Chiropractor | 111NX0800X | DC 25093 | CA | Primary |
Addresses
Primary practice location
610 North Central Ave
Suite 202
Glendale, CA 91203
Mailing address
610 North Central Ave
Suite 202
Glendale, CA 91203
Phone (818) 244-6792
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC 25093 | CA | MD | Orthopedic Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344816000000",
"number": "1588911150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 NORTH CENTRAL AVE",
"address_2": "SUITE 202",
"city": "GLENDALE",
"state": "CA",
"postal_code": "91203",
"telephone_number": "818-244-6792",
"fax_number": "818-244-7477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 NORTH CENTRAL AVE",
"address_2": "SUITE 202",
"city": "GLENDALE",
"state": "CA",
"postal_code": "91203",
"telephone_number": "818-244-6792",
"fax_number": "818-244-7477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POURDAVOOD",
"first_name": "MARJAN",
"middle_name": "RAZI",
"credential": "D.C., QME",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-13",
"last_updated": "2012-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "111NX0800X",
"taxonomy_group": "",
"desc": "Chiropractor, Orthopedic",
"state": "CA",
"license": "DC 25093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.