Provider Demographics
NPI:1558434910
Name:LEUSCHEN, FAITH ELAINE (DC)
Entity Type:Individual
Prefix:DR
First Name:FAITH
Middle Name:ELAINE
Last Name:LEUSCHEN
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 1:515 N SEPULVEDA BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-6748
Mailing Address - Country:US
Mailing Address - Phone:310-372-2687
Mailing Address - Fax:310-372-3577
Practice Address - Street 1:515 N SEPULVEDA BLVD STE B
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-6748
Practice Address - Country:US
Practice Address - Phone:310-372-2687
Practice Address - Fax:310-372-3577
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24822111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC24822AMedicare ID - Type Unspecified
CAY19398Medicare UPIN