Provider Demographics
NPI:1225188683
Name:TAMARA & JEFFREY PLOTKIN
Entity Type:Organization
Organization Name:TAMARA & JEFFREY PLOTKIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:PLOTKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-887-0651
Mailing Address - Street 1:8111 CANOGA AVE
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-4103
Mailing Address - Country:US
Mailing Address - Phone:818-887-0651
Mailing Address - Fax:818-887-5620
Practice Address - Street 1:8111 CANOGA AVE
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91304-4103
Practice Address - Country:US
Practice Address - Phone:818-887-0651
Practice Address - Fax:818-887-5620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21473111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty