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General NPI Number Information
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NPI Number | 1265620660
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Entity Type | Organization
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Legal Business Name | SLOBODIEN CHIROPRACTIC INC. APC
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Dates
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Enumeration Date | 10/10/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 50 N LA CIENEGA BLVD SUITE 204
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2227
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Country | US
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Telephone | 310-652-3032
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Fax | 310-360-9505
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Provider Business Mailing Address
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Address Line | 50 N LA CIENEGA BLVD SUITE 204
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2227
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Country | US
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Telephone | 310-652-3032
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Fax | 310-360-9505
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. DAVID STILES SLOBODIEN
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Credential | DC
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Telephone | 310-652-3032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | DC23112
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License Number State | CA
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