Provider Demographics
NPI:1972635480
Name:POWER, MIKE (DC)
Entity type:Individual
Prefix:DR
First Name:MIKE
Middle Name:
Last Name:POWER
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 1:6075 FRANKLIN AVE
Mailing Address - Street 2:#238
Mailing Address - City:HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90028-5566
Mailing Address - Country:US
Mailing Address - Phone:323-957-5722
Mailing Address - Fax:310-575-9885
Practice Address - Street 1:2019 SAWTELLE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6229
Practice Address - Country:US
Practice Address - Phone:310-575-1955
Practice Address - Fax:310-575-9885
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 28723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor