Provider Demographics
NPI:1679913404
Name:VASHALO EAST LA
Entity Type:Organization
Organization Name:VASHALO EAST LA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EFREN
Authorized Official - Middle Name:B
Authorized Official - Last Name:LAPIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-954-7400
Mailing Address - Street 1:311 N ROBERTSON BLVD
Mailing Address - Street 2:SUITE 789
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1705
Mailing Address - Country:US
Mailing Address - Phone:323-954-7400
Mailing Address - Fax:323-954-7402
Practice Address - Street 1:5655 E BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-2803
Practice Address - Country:US
Practice Address - Phone:323-954-7400
Practice Address - Fax:323-954-7402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty