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General NPI Number Information
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NPI Number | 1801173281
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Entity Type | Individual
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Provider Name | STEVEN JEFF JENNEWEIN D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/13/2011
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Last Update Date | 11/13/2011
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Provider Practice Location Address
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Address Line | 25448 NARBONNE AVE
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City | LOMITA
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State | CA
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Zip | 90717-2124
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Country | US
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Telephone | 310-326-2804
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Fax |
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Provider Business Mailing Address
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Address Line | 25448 NARBONNE AVE
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City | LOMITA
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State | CA
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Zip | 90717-2124
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Country | US
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Telephone | 310-326-2804
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 15961
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License Number State | CA
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