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General NPI Number Information
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NPI Number | 1386703213
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Entity Type | Organization
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Legal Business Name | WEBER CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 05/14/2009
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Provider Practice Location Address
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Address Line | 322 N LA BREA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90036-2518
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Country | US
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Telephone | 323-935-9777
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Fax |
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Provider Business Mailing Address
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Address Line | 322 N LA BREA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90036-2518
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Country | US
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Telephone | 323-935-9777
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | DR. JENNIFER CUNHA BOTELHO
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Credential | D.C.
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Telephone | 323-935-9777
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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 | COR 716
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License Number State | CA
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