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NPI Code Detail

MEDICARE: LEROY R PERRY JR DC A CHIROPRACTIC CORPORATION

MEDICARE: LEROY R PERRY JR DC A CHIROPRACTIC CORPORATION
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
1111N00000XChiropractorCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ZZZ91851ZOTHERCABC BS NUMBER

General Provider Information

NPI Number : 1508987595
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEROY R PERRY JR DC A CHIROPRACTIC CORPORATION
Provider Business Mailing Address
First Line : 3283 MOTOR AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-3709
Country : US
Telephone Number : 310-559-6900
Fax Number : 310-836-8664
Provider Business Practice Location Address
First Line : 3283 MOTOR AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-3709
Country : US
Telephone Number : 310-559-6900
Fax Number : 310-836-8664
Authorized Official
Title or Position : PRESIDENT
Name : DR. LEROY R PERRY JR.
Credential : D.C.
Telephone Number : 310-559-6900
Provider Enumeration Date : 04/03/2007
Last Update Date : 01/11/2013

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