Healthcare Provider Details

I. General information

NPI: 1528169869
Provider Name (Legal Business Name): VICTOR HELO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12103 VENTURA PL
STUDIO CITY CA
91604-2605
US

IV. Provider business mailing address

PO BOX 55901
SHERMAN OAKS CA
91413-0901
US

V. Phone/Fax

Practice location:
  • Phone: 818-487-9100
  • Fax: 818-487-9111
Mailing address:
  • Phone: 818-487-9100
  • Fax: 818-487-9111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC27771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: