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General NPI Number Information
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NPI Number | 1003011289
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Entity Type | Organization
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Legal Business Name | KATLEIN PROFESSIONAL CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 12080 VENTURA PL STE B
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City | STUDIO CITY
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State | CA
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Zip | 91604-2632
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Country | US
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Telephone | 818-985-5500
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Fax | 818-985-5502
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Provider Business Mailing Address
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Address Line | 12080 VENTURA PL STE B
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City | STUDIO CITY
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State | CA
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Zip | 91604-2632
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Country | US
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Telephone | 818-985-5500
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Fax | 818-985-5502
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY DAVID KATLEIN
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Credential | DC
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Telephone | 818-985-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC28386
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License Number State | CA
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