Provider Demographics
NPI:1639222946
Name:TIRSCH, JEFFREY B (DC)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:B
Last Name:TIRSCH
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 1:6400 CANOGA AVE STE 333
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-2492
Mailing Address - Country:US
Mailing Address - Phone:818-703-8480
Mailing Address - Fax:818-703-9125
Practice Address - Street 1:6400 CANOGA AVE STE 333
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-2492
Practice Address - Country:US
Practice Address - Phone:818-703-8480
Practice Address - Fax:818-703-9125
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23422111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC23422Medicare ID - Type Unspecified