Provider Demographics
NPI:1962641696
Name:CANTOR CHIROPRACTIC
Entity Type:Organization
Organization Name:CANTOR CHIROPRACTIC
Other - Org Name:THE LOS ANGELES HEALTH & WELLNESS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/DR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-273-8325
Mailing Address - Street 1:3374 OAKDELL RD
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-4140
Mailing Address - Country:US
Mailing Address - Phone:323-273-8325
Mailing Address - Fax:310-289-9863
Practice Address - Street 1:206 S ROBERTSON BLVD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2811
Practice Address - Country:US
Practice Address - Phone:310-273-3015
Practice Address - Fax:310-289-9863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 30980111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty