Healthcare Provider Details

I. General information

NPI: 1700911310
Provider Name (Legal Business Name): ZUCKER AND VANVAKARIS CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12930 VENTURA BLVD STE 226C
STUDIO CITY CA
91604-2200
US

IV. Provider business mailing address

12930 VENTURA BLVD STE 226C
STUDIO CITY CA
91604-2200
US

V. Phone/Fax

Practice location:
  • Phone: 818-995-4472
  • Fax:
Mailing address:
  • Phone: 818-995-4472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC25954
License Number StateCA

VIII. Authorized Official

Name: MR. DAN M ZUCKER
Title or Position: CEO
Credential: D.C.
Phone: 818-995-4472