Provider Demographics
NPI:1285834382
Name:ABSOLUTE HEALTH OF LOS ANGELES LLC
Entity Type:Organization
Organization Name:ABSOLUTE HEALTH OF LOS ANGELES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-659-1100
Mailing Address - Street 1:432 S SAN VICENTE BLVD # 250
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4108
Mailing Address - Country:US
Mailing Address - Phone:310-659-1100
Mailing Address - Fax:
Practice Address - Street 1:432 S SAN VICENTE BLVD # 250
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4108
Practice Address - Country:US
Practice Address - Phone:310-659-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty