Provider Demographics
NPI:1972308427
Name:O'HERN, MICHAEL KENT (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:KENT
Last Name:O'HERN
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 S FAIR OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-2524
Mailing Address - Country:US
Mailing Address - Phone:626-898-2559
Mailing Address - Fax:
Practice Address - Street 1:2114 HYPERION AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-4708
Practice Address - Country:US
Practice Address - Phone:323-662-4401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36069111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor