Provider Demographics
NPI:1447479860
Name:SCALE, EDWARD HERMAN (DC)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:HERMAN
Last Name:SCALE
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 1:2617 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2733
Mailing Address - Country:US
Mailing Address - Phone:310-545-9493
Mailing Address - Fax:310-356-4847
Practice Address - Street 1:240 CENTER ST
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-4206
Practice Address - Country:US
Practice Address - Phone:310-356-4843
Practice Address - Fax:310-356-4847
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111NS0005X111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician