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NPI Code Detail

MEDICARE: DR. ALEJANDRO BOLIVAR PLATON D.C., C.C.S.P

MEDICARE: DR. ALEJANDRO BOLIVAR PLATON D.C., C.C.S.P
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor21096CA
2111NS0005XSports Physician Chiropractor21096CA

General Provider Information

NPI Number : 1275852543
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEJANDRO BOLIVAR PLATON D.C., C.C.S.P
Provider Business Mailing Address
First Line : 2975 WILSHIRE BLVD
Second Line : SUITE 201
City : LOS ANGELES
State : CA
Zip : 90010-1107
Country : US
Telephone Number : 213-384-8903
Fax Number : 213-384-7338
Provider Business Practice Location Address
First Line : 2975 WILSHIRE BLVD
Second Line : SUITE 201
City : LOS ANGELES
State : CA
Zip : 90010-1107
Country : US
Telephone Number : 213-384-8903
Fax Number : 213-384-7338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2010
Last Update Date : 05/25/2010

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