Healthcare Provider Details

I. General information

NPI: 1639222946
Provider Name (Legal Business Name): JEFFREY B. TIRSCH DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 DE SOTO AVE STE 210
WOODLAND HILLS CA
91367-5137
US

IV. Provider business mailing address

5955 DE SOTO AVE STE 210
WOODLAND HILLS CA
91367-5137
US

V. Phone/Fax

Practice location:
  • Phone: 818-458-4201
  • Fax:
Mailing address:
  • Phone: 818-703-8480
  • Fax: 818-703-9125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number23422
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number23422
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC23422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: