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General NPI Number Information
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NPI Number | 1508122342
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Entity Type | Organization
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Legal Business Name | MICHAEL BILLAUER D.C., A PROFESSIONAL CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 04/05/2012
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Last Update Date | 04/18/2012
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Provider Practice Location Address
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Address Line | 2901 WASHINGTON BLVD
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5546
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Country | US
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Telephone | 310-306-1983
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 WASHINGTON BLVD
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5546
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Country | US
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Telephone | 310-306-1983
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL BILLAUER
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Credential | D.C.
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Telephone | 310-306-1983
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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 | DC28033
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License Number State | CA
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