Provider Demographics
NPI:1114196060
Name:DAWIDOWICZ, LEAH (DC)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:
Last Name:DAWIDOWICZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7531 SANTA MONICA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-6458
Mailing Address - Country:US
Mailing Address - Phone:323-654-7716
Mailing Address - Fax:323-654-7771
Practice Address - Street 1:7531 SANTA MONICA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-6458
Practice Address - Country:US
Practice Address - Phone:323-654-7716
Practice Address - Fax:323-654-7771
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21199111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor