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NPI Code Detail

MEDICARE: DR. MIKE POWER D.C.

MEDICARE: DR. MIKE POWER 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
1111N00000XChiropractorDC 28723CA

General Provider Information

NPI Number : 1972635480
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIKE POWER D.C.
Provider Business Mailing Address
First Line : 6075 FRANKLIN AVE
Second Line : #238
City : HOLLYWOOD
State : CA
Zip : 90028-5566
Country : US
Telephone Number : 323-957-5722
Fax Number : 310-575-9885
Provider Business Practice Location Address
First Line : 2019 SAWTELLE BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-6229
Country : US
Telephone Number : 310-575-1955
Fax Number : 310-575-9885
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2007
Last Update Date : 07/08/2007

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