Provider Demographics
NPI:1013087899
Name:SYNDER, NEAL G (DC)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:G
Last Name:SYNDER
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 1:11340 W OLYMPIC BLVD
Mailing Address - Street 2:SUITE 138
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1611
Mailing Address - Country:US
Mailing Address - Phone:310-473-4400
Mailing Address - Fax:310-473-7752
Practice Address - Street 1:11340 W OLYMPIC BLVD
Practice Address - Street 2:SUITE 138
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1611
Practice Address - Country:US
Practice Address - Phone:310-473-4400
Practice Address - Fax:310-473-7752
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12545111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC12545Medicare PIN
CAT17384Medicare UPIN