Provider Demographics
NPI:1114319753
Name:CHERNICH CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:CHERNICH CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERNICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-244-3960
Mailing Address - Street 1:1602 E CHEVY CHASE DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-2804
Mailing Address - Country:US
Mailing Address - Phone:818-244-3960
Mailing Address - Fax:818-244-3963
Practice Address - Street 1:1602 E CHEVY CHASE DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-2804
Practice Address - Country:US
Practice Address - Phone:818-244-3960
Practice Address - Fax:818-244-3963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17649111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty