Provider Demographics
NPI:1437579356
Name:GRUPPINA, YULIYA (DC)
Entity Type:Individual
Prefix:DR
First Name:YULIYA
Middle Name:
Last Name:GRUPPINA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12030 RIVERSIDE DR
Mailing Address - Street 2:STE. A
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3749
Mailing Address - Country:US
Mailing Address - Phone:818-655-9900
Mailing Address - Fax:
Practice Address - Street 1:12030 RIVERSIDE DR
Practice Address - Street 2:STE. A
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91607-3749
Practice Address - Country:US
Practice Address - Phone:818-655-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32754111N00000X
CAAC 16330171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist