Healthcare Provider Details
I. General information
NPI: 1639084221
Provider Name (Legal Business Name): BERNSTEIN NIKROO ELITE SPORTS CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
455 N MESA DR STE 8W
MESA AZ
85201-5996
US
IV. Provider business mailing address
PO BOX 628
WOODLAND HILLS CA
91365-0628
US
V. Phone/Fax
- Phone: 602-887-7878
- Fax: 818-222-1138
- Phone: 602-887-7878
- Fax: 818-222-1138
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MATTHEW
BERNSTEIN
Title or Position: OWNER
Credential: DC
Phone: 602-887-7878