Provider Demographics
NPI:1477571867
Name:CATHCART, JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:CATHCART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 WESTWOOD BLVD
Mailing Address - Street 2:SUITE #110
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4650
Mailing Address - Country:US
Mailing Address - Phone:310-475-3488
Mailing Address - Fax:310-475-3574
Practice Address - Street 1:1990 WESTWOOD BLVD
Practice Address - Street 2:SUITE #110
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4650
Practice Address - Country:US
Practice Address - Phone:310-475-3488
Practice Address - Fax:310-475-3574
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15768111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician