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NPI Code Detail

MEDICARE: BOSTEN CHIROPRACTIC A CORPORATION

MEDICARE: BOSTEN CHIROPRACTIC A CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorDC17611CA
2111N00000XChiropractor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1WDC17611AOTHERP PIN

General Provider Information

NPI Number : 1659389179
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOSTEN CHIROPRACTIC A CORPORATION
Provider Business Mailing Address
First Line : 3283 MOTOR AVENUE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034
Country : US
Telephone Number : 310-559-6900
Fax Number : 310-836-8664
Provider Business Practice Location Address
First Line : 3283 MOTOR AVENUE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034
Country : US
Telephone Number : 310-559-6900
Fax Number : 310-836-8664
Authorized Official
Title or Position : PRESIDENT
Name : MRS. MICHELLE DORENE CLEVELAND-BOSTEN
Credential : D.C.
Telephone Number : 310-559-6900
Provider Enumeration Date : 08/03/2006
Last Update Date : 01/05/2015

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Directions to “BOSTEN CHIROPRACTIC A CORPORATION ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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