Provider Demographics
NPI:1780681502
Name:HURST CHIROPRACTIC INC
Entity Type:Organization
Organization Name:HURST CHIROPRACTIC INC
Other - Org Name:MICHAEL HURST DC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-345-9100
Mailing Address - Street 1:7100 HAYVENHURST AVE. #209
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406
Mailing Address - Country:US
Mailing Address - Phone:818-345-9100
Mailing Address - Fax:818-345-9104
Practice Address - Street 1:7100 HAYVENHURST AVE. #209
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406
Practice Address - Country:US
Practice Address - Phone:818-345-9100
Practice Address - Fax:818-345-9104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27608111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
V02015Medicare ID - Type Unspecified