Provider Demographics
NPI:1578747929
Name:SORKIN, ELY (DC)
Entity Type:Individual
Prefix:
First Name:ELY
Middle Name:
Last Name:SORKIN
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 1:7111 WINNETKA AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3646
Mailing Address - Country:US
Mailing Address - Phone:818-313-9119
Mailing Address - Fax:818-888-3331
Practice Address - Street 1:7111 WINNETKA AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91306-3646
Practice Address - Country:US
Practice Address - Phone:818-313-9119
Practice Address - Fax:818-888-3331
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27174111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor