Provider Demographics
NPI:1356432991
Name:BERLIN, ELLIOT I (DC)
Entity type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:I
Last Name:BERLIN
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 1:6221 WILSHIRE BLVD
Mailing Address - Street 2:SUITE #518
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5201
Mailing Address - Country:US
Mailing Address - Phone:800-998-1959
Mailing Address - Fax:323-549-0440
Practice Address - Street 1:6221 WILSHIRE BLVD
Practice Address - Street 2:SUITE #518
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5201
Practice Address - Country:US
Practice Address - Phone:800-998-1959
Practice Address - Fax:323-549-0440
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19447Medicare ID - Type UnspecifiedMEDICARE