Khatiblou Chiropractic Corp

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

KHATIBLOU CHIROPRACTIC CORP

Practice address

2900 Bristol St Ste J103
Costa Mesa, CA 92626-7918

Phone

(949) 742-2087

NPI assigned

Feb 7, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Khodayar Khatiblou, DCNPI 1598315244

Title

President

Phone

(949) 742-2087

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Khodayar Khatiblou

  • Chiropractor
  • Costa Mesa, CA
  • NPI 1598315244
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649289600000",
    "number": "1972257152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST STE J103",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267918",
            "telephone_number": "949-742-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 BRISTOL ST STE J103",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926267918",
            "telephone_number": "949-742-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHATIBLOU CHIROPRACTIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A",
        "authorized_official_last_name": "KHATIBLOU",
        "authorized_official_first_name": "KHODAYAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-742-2087",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iman Ayub Khan
• Maryalice Elizabeth Khan, RN PHN
• Munazza Khan, M.D.
• Roheena Khan
• Zoya Fatima Khan
• Khodayar Khatiblou
• Khiem D. Dao, MD, Inc.
• Mariana Khoury
• Kyndall Rae Kieler
• Mia'Ariarna Kilekas, PA-C, MSPA

• Chiropractor in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.