Healthcare Provider Details

I. General information

NPI: 1346406527
Provider Name (Legal Business Name): SPEARMAN CHIROPRACTIC PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 08/06/2008
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

4610 NOB HILL DR
LOS ANGELES CA
90065-4121
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: DR. MICHAEL STEWART SPEARMAN
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C.
Phone: 323-663-1066