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General NPI Number Information
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NPI Number | 1205270717
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Entity Type | Organization
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Legal Business Name | YANIV FARBENBLOOM, PROFESSIONAL CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 16133 VENTURA BLVD STE 700
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City | ENCINO
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State | CA
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Zip | 91436-2406
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Country | US
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Telephone | 818-377-7444
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Fax | 415-634-1356
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Provider Business Mailing Address
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Address Line | 16133 VENTURA BLVD STE 700
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City | ENCINO
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State | CA
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Zip | 91436-2406
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Country | US
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Telephone | 818-377-7444
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Fax | 415-634-1356
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. YANIV FARBENBLOOM
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Credential | DC
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Telephone | 818-377-7444
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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 | 25863
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License Number State | CA
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