Provider Demographics
NPI:1730103243
Name:CHENEY, ISAAC (DC)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:
Last Name:CHENEY
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 1:4444 W RIVERSIDE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4073
Mailing Address - Country:US
Mailing Address - Phone:818-846-0245
Mailing Address - Fax:818-845-8543
Practice Address - Street 1:4444 W RIVERSIDE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4073
Practice Address - Country:US
Practice Address - Phone:818-846-0245
Practice Address - Fax:818-845-8543
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15166DC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT17991Medicare UPIN