Provider Demographics
NPI:1609870088
Name:MEYER CHIROPRATIC
Entity Type:Organization
Organization Name:MEYER CHIROPRATIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-788-6817
Mailing Address - Street 1:17401 VENTURA BLVD
Mailing Address - Street 2:STE A29
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3865
Mailing Address - Country:US
Mailing Address - Phone:818-788-6817
Mailing Address - Fax:818-464-0138
Practice Address - Street 1:17401 VENTURA BLVD
Practice Address - Street 2:STE A29
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3865
Practice Address - Country:US
Practice Address - Phone:818-788-6817
Practice Address - Fax:818-464-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23554111N00000X
CAPT29857225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABC23544OtherBLUE CROSS
CAU55277Medicare UPIN
CAW18610Medicare ID - Type Unspecified