Healthcare Provider Details

I. General information

NPI: 1811148943
Provider Name (Legal Business Name): CHRISTOPHER MANUEL CLEVELAND D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2008
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S FLOWER ST SUITE# 204
LOS ANGELES CA
90017-4625
US

IV. Provider business mailing address

801 S FLOWER ST SUITE# 204
LOS ANGELES CA
90017-4625
US

V. Phone/Fax

Practice location:
  • Phone: 213-481-7026
  • Fax: 213-623-9985
Mailing address:
  • Phone: 213-481-7026
  • Fax: 213-623-9985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC27977
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC27977
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License NumberDC27977
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberDC27977
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: