Provider Demographics
NPI:1619964616
Name:YOSER, ADAM J (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:J
Last Name:YOSER
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 1:13050 SAN VICENTE BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-4800
Mailing Address - Country:US
Mailing Address - Phone:310-260-7611
Mailing Address - Fax:310-260-8561
Practice Address - Street 1:13050 SAN VICENTE BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-4800
Practice Address - Country:US
Practice Address - Phone:310-260-7611
Practice Address - Fax:310-260-8561
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20047111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0200470OtherBLUE SHIELD
4309694OtherAETNA
4309694OtherAETNA
U10507Medicare UPIN