Provider Demographics
NPI:1174656680
Name:DR. BRIGITTE ROZENBERG CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:DR. BRIGITTE ROZENBERG CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIGITTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-842-9113
Mailing Address - Street 1:4340 OVERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4117
Mailing Address - Country:US
Mailing Address - Phone:310-842-9113
Mailing Address - Fax:310-842-9116
Practice Address - Street 1:4340 OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4117
Practice Address - Country:US
Practice Address - Phone:310-842-9113
Practice Address - Fax:310-842-9116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU59791Medicare UPIN
CADC23971AMedicare ID - Type UnspecifiedLICENCE NUMBER