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General NPI Number Information
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NPI Number | 1265811293
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Entity Type | Organization
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Legal Business Name | TOTAL BODY ALLIANCE INC
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Dates
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Enumeration Date | 05/22/2015
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Last Update Date | 05/22/2015
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Provider Practice Location Address
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Address Line | 10351 WILSHIRE BLVD # 202
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City | LOS ANGELES
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State | CA
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Zip | 90024-4736
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Country | US
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Telephone | 818-216-8152
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Fax |
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Provider Business Mailing Address
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Address Line | 10351 WILSHIRE BLVD # 202
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City | LOS ANGELES
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State | CA
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Zip | 90024-4736
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Country | US
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Telephone | 818-216-8152
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. LEILA GHARACHE
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Credential |
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Telephone | 818-216-8152
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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 | 1841445020
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G50570
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License Number State | CA
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