Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC15136 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | DC15136 | CA |
NPI | 1710903927 |
---|---|
Provider Name | Joel E. Bienenfeld |
First Address | Los Angeles, CA 90034-1051 |
Second Address | Los Angeles, CA 90034-1051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 09/05/2014 |