| Wilson C Park Chiropractic Corp | |
|
2940 Westwood Blvd, #1, Los Angeles, CA 90064-4145 | |
| (310) 869-0536 | |
| (310) 441-3727 |
| Full Name | Wilson C Park Chiropractic Corp |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 2940 Westwood Blvd, Los Angeles, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427210822 | NPI | - | NPPES |
| DC251660 | Other | CA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | DC25166 (California) | Primary |
| Provider Name | Wilson Park |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548337587 PECOS PAC ID: 8527114511 Enrollment ID: I20090916000230 |
| Mailing Address | Practice Location Address |
|---|---|
| Wilson C Park Chiropractic Corp 2940 Westwood Blvd, #1, Los Angeles, CA 90064 Ph: (310) 869-0536 | Wilson C Park Chiropractic Corp 2940 Westwood Blvd, #1, Los Angeles, CA 90064-4145 Ph: (310) 869-0536 |
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