Individual
BILLY MIKEL LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
24007 VENTURA BLVD, SUITE 130, CALABASAS, CA 91302-2568
(818) 591-8847
(818) 591-0549
Mailing address
24009 VENTURA BLVD, STE 235, CALABASAS, CA 91302-1423
(818) 591-8847
(818) 591-0549
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC27936
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202344792
TAX ID #
CA
01
—
DC27936
LICENSE #
CA
01
—
ZZZ64988Z
BC-BS GROUP ID#
CA
Enumeration date
01/22/2007
Last updated
10/04/2021
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