Healthcare Provider Details

I. General information

NPI: 1013108398
Provider Name (Legal Business Name): FRANK JOSEPH DEMARCO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 08/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17337 VENTURA BLVD STE 106
ENCINO CA
91316-3978
US

IV. Provider business mailing address

17337 VENTURA BLVD STE 106
ENCINO CA
91316-3978
US

V. Phone/Fax

Practice location:
  • Phone: 818-788-2984
  • Fax:
Mailing address:
  • Phone: 818-788-2984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberDC17666
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: