Provider Demographics
NPI:1902027998
Name:EHRLICH, BETTY ANN (DC)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:ANN
Last Name:EHRLICH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10780 SANTA MONICA BLVD
Mailing Address - Street 2:#245
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4749
Mailing Address - Country:US
Mailing Address - Phone:310-474-2331
Mailing Address - Fax:310-474-8115
Practice Address - Street 1:10780 SANTA MONICA BLVD
Practice Address - Street 2:#245
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4749
Practice Address - Country:US
Practice Address - Phone:310-474-2331
Practice Address - Fax:310-474-8115
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17116111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition