Healthcare Provider Details

I. General information

NPI: 1407486087
Provider Name (Legal Business Name): DR YUDKIN HEALING HANDS CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7260 W SUNSET BLVD STE 204
LOS ANGELES CA
90046-3417
US

IV. Provider business mailing address

7260 W SUNSET BLVD STE 204
LOS ANGELES CA
90046-3417
US

V. Phone/Fax

Practice location:
  • Phone: 323-851-7804
  • Fax: 323-851-7878
Mailing address:
  • Phone: 323-851-7804
  • Fax: 323-851-7878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: VITALIY YUDKIN
Title or Position: PRESIDENT
Credential: DC
Phone: 323-851-7804