Provider Demographics
NPI:1447692991
Name:GLENN FISCHEL CHIROPRACTIC INC
Entity type:Organization
Organization Name:GLENN FISCHEL CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:310-477-4531
Mailing Address - Street 1:11545 W OLYMPIC BLVD
Mailing Address - Street 2:A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1508
Mailing Address - Country:US
Mailing Address - Phone:310-477-4531
Mailing Address - Fax:310-477-2443
Practice Address - Street 1:11545 W OLYMPIC BLVD
Practice Address - Street 2:A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1508
Practice Address - Country:US
Practice Address - Phone:310-477-4531
Practice Address - Fax:310-477-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty