Provider Demographics
NPI:1215006655
Name:KANTOR CHIROPRACTIC INC.
Entity type:Organization
Organization Name:KANTOR CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:D
Authorized Official - Last Name:KANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-917-4343
Mailing Address - Street 1:8281 MELROSE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-6890
Mailing Address - Country:US
Mailing Address - Phone:323-917-4343
Mailing Address - Fax:
Practice Address - Street 1:8281 MELROSE AVE STE 201
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-6890
Practice Address - Country:US
Practice Address - Phone:323-917-4343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC17544Medicare UPIN
CADC17544Medicare ID - Type Unspecified