Provider Demographics
NPI:1497826077
Name:SHER, JAYSON IVAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAYSON
Middle Name:IVAN
Last Name:SHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11775 BELLAGIO RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-2114
Mailing Address - Country:US
Mailing Address - Phone:310-476-8896
Mailing Address - Fax:310-476-8428
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:310-470-0154
Practice Address - Fax:310-476-8428
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC11393111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health