Provider Demographics
NPI:1255666756
Name:ELKINS, NATHANIEL R (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:R
Last Name:ELKINS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11500 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE 364
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1524
Mailing Address - Country:US
Mailing Address - Phone:310-445-8300
Mailing Address - Fax:310-933-4679
Practice Address - Street 1:11500 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 364
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1524
Practice Address - Country:US
Practice Address - Phone:310-445-8300
Practice Address - Fax:310-933-4679
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 31369111N00000X
WACH 60106740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor