Provider Demographics
NPI:1841309572
Name:BERLIN & WITTENBERG CHIROPRACTIC CORP.
Entity type:Organization
Organization Name:BERLIN & WITTENBERG CHIROPRACTIC CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:WITTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-549-0070
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:323-549-0070
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:323-549-0070
Practice Address - Fax:323-549-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29658111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19447Medicare ID - Type Unspecified