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General NPI Number Information
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NPI Number | 1780746685
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Entity Type | Organization
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Legal Business Name | EARL L CHERNIAK DPM A PROF CORP
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 3984 SO FIGUEROA ST
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City | LOS ANGELES
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State | CA
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Zip | 90037
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Country | US
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Telephone | 213-747-7272
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Fax | 310-476-8003
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Provider Business Mailing Address
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Address Line | 11724 GWYNNE LANE
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City | LOS ANGELES
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State | CA
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Zip | 90077
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Country | US
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Telephone | 310-476-5397
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Fax | 310-476-8003
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Authorized Official
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Title or Position | PRESIDENT
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Name | EARL LOWELL CHERNIAK
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Credential | DPM
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Telephone | 310-476-5397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E1180
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License Number State | CA
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