Provider Demographics
NPI:1609930155
Name:BERLIN CHIROPRACTIC CORP
Entity Type:Organization
Organization Name:BERLIN CHIROPRACTIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:I
Authorized Official - Last Name:BERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-549-0070
Mailing Address - Street 1:6221 WILSHIRE BLVD
Mailing Address - Street 2:518
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:323-549-0070
Mailing Address - Fax:323-549-0440
Practice Address - Street 1:6221 WILSHIRE BLVD
Practice Address - Street 2:518
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:323-549-0070
Practice Address - Fax:323-549-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty