MEDICARE: HEAL LA LLC

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

General Provider Information

NPI Number	:	1891627931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAL LA LLC

Provider Business Mailing Address
First Line	:	3201 N SEPULVEDA BLVD STE A
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-2463
Country	:	US
Telephone Number	:	310-910-1735
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 N SEPULVEDA BLVD STE A
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-2463
Country	:	US
Telephone Number	:	310-910-1735
Fax Number	:

Authorized Official
Title or Position	:	CO-FOUNDER
Name	:	BRENDA PERRY
Credential	:	PSYD, DAOM
Telephone Number	:	503-333-1837

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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