Healthcare Provider Details

I. General information

NPI: 1538501820
Provider Name (Legal Business Name): ESUDRI CHIROPRACTIC APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2013
Last Update Date: 07/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 CANOGA AVE STE 333
WOODLAND HILLS CA
91367-2492
US

IV. Provider business mailing address

6400 CANOGA AVE STE 333
WOODLAND HILLS CA
91367-2492
US

V. Phone/Fax

Practice location:
  • Phone: 818-710-0800
  • Fax:
Mailing address:
  • Phone: 818-710-0800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC26546
License Number StateCA

VIII. Authorized Official

Name: DAVID ESUDRI
Title or Position: PRESIDENT
Credential: D.C.
Phone: 818-710-0800