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General NPI Number Information
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NPI Number | 1104034206
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Entity Type | Organization
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Legal Business Name | JON C.OATEY, A CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9911 W PICO BLVD STE 1215
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City | LOS ANGELES
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State | CA
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Zip | 90035-2709
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Country | US
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Telephone | 310-553-3970
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Fax | 310-553-3971
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Provider Business Mailing Address
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Address Line | 9911 W PICO BLVD STE 1215
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City | LOS ANGELES
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State | CA
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Zip | 90035-2709
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Country | US
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Telephone | 310-553-3970
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Fax | 310-553-3971
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Authorized Official
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Title or Position | OWNER
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Name | JON CHARLES OATEY
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Credential | D.C.
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Telephone | 310-553-3970
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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 | DC23674
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License Number State | CA
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