Healthcare Provider Details

I. General information

NPI: 1144435223
Provider Name (Legal Business Name): MICHAEL S SPEARMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 10/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1279 N BERENDO ST
LOS ANGELES CA
90029-1601
US

IV. Provider business mailing address

1279 N BERENDO ST
LOS ANGELES CA
90029-1601
US

V. Phone/Fax

Practice location:
  • Phone: 323-663-1066
  • Fax:
Mailing address:
  • Phone: 323-663-1066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberDC24621
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: