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Organization
WILSON C PARK CHIROPRACTIC CORP
Active
Organization
WILSON C PARK CHIROPRACTIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILSON PARK DC (CHIROPRACTOR)
(310) 869-0536
Entity
Organization
Contact information
Practice address
2940 WESTWOOD BLVD, #1, LOS ANGELES, CA 90064-4145
(310) 869-0536
(310) 441-3727
Mailing address
2940 WESTWOOD BLVD, #1, LOS ANGELES, CA 90064
(310) 869-0536
(310) 441-3727
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC25166
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC251660
BLUE SHIELD
CA
Enumeration date
06/26/2008
Last updated
06/26/2008
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