Provider Demographics
NPI:1508947813
Name:MITTLEMAN, SETH (DC)
Entity Type:Individual
Prefix:MR
First Name:SETH
Middle Name:
Last Name:MITTLEMAN
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 1:131 N EL MOLINO AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1873
Mailing Address - Country:US
Mailing Address - Phone:626-793-9915
Mailing Address - Fax:626-793-4654
Practice Address - Street 1:131 N EL MOLINO AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1873
Practice Address - Country:US
Practice Address - Phone:626-793-9915
Practice Address - Fax:626-793-4654
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor