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General NPI Number Information
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NPI Number | 1821137134
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Entity Type | Individual
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Provider Name | ERIC E. GOFNUNG D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6221 WILSHIRE BLVD STE 604
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City | LOS ANGELES
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State | CA
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Zip | 90048-5215
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Country | US
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Telephone | 323-931-3494
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Fax | 323-931-3499
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Provider Business Mailing Address
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Address Line | 6221 WILSHIRE BLVD STE 604
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City | LOS ANGELES
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State | CA
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Zip | 90048-5215
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Country | US
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Telephone | 323-931-3494
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Fax | 323-931-3499
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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 | DC-24383
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License Number State | CA
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