Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0400X | Rehabilitation Chiropractor | DC27977 | CA |
N | 111NS0005X | Chiropractic Sports Physician | DC27977 | CA |
N | 111NX0100X | Occupational Health | DC27977 | CA |
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC27977 | CA |
NPI | 1811148943 |
---|---|
Provider Name | Dr. Christopher Manuel Cleveland |
First Address | Los Angeles, CA 90017-4625 |
Second Address | Los Angeles, CA 90017-4625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2008 |
Last Update Date | 07/10/2008 |