Provider Demographics
NPI:1396770368
Name:MARKOVITZ, HARVEY J (DC)
Entity type:Individual
Prefix:
First Name:HARVEY
Middle Name:J
Last Name:MARKOVITZ
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 1:831 BAY AVE
Mailing Address - Street 2:STE 1E
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010-2105
Mailing Address - Country:US
Mailing Address - Phone:831-515-8429
Mailing Address - Fax:
Practice Address - Street 1:831 BAY AVE
Practice Address - Street 2:STE 1E
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2105
Practice Address - Country:US
Practice Address - Phone:831-515-8429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0114750111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0114750Medicare ID - Type Unspecified