MEDICARE: DR. ROBERT ZERAVICA D.C.

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
1	111N00000X	Chiropractor	DC26527	CA

General Provider Information

NPI Number	:	1417125394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT ZERAVICA D.C.

Provider Business Mailing Address
First Line	:	4444 LANKERSHIM BLVD STE 105
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-2357
Country	:	US
Telephone Number	:	805-622-7632
Fax Number	:

Provider Business Practice Location Address
First Line	:	4444 LANKERSHIM BLVD STE 105
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-2357
Country	:	US
Telephone Number	:	805-622-7632
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	11/27/2018

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