Dana E. Clark D.C. Inc

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC28616 Issued in CA

Legal business name

DANA E. CLARK D.C. INC

Doing business as

Pacific Coast Spine and Rehab

Practice address

11110 Ohio Ave Ste 108
Los Angeles, CA 90025-6345

Phone

(310) 473-7130

Fax

(310) 473-5077

NPI assigned

Sep 21, 2006

Last updated

Jan 9, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dana Elmore Clark, DCNPI 1750314647

Title

Director

Phone

(310) 473-7130

Specialties & licenses 1

Addresses

Other names 1

• Pacific Coast Spine and Rehab Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dana Elmore Clark, D.C.

  • Chiropractor
  • Los Angeles, CA
  • NPI 1750314647
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1629177340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 OHIO AVE STE 108",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256345",
            "telephone_number": "310-473-7130",
            "fax_number": "310-473-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 OHIO AVE STE 108",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256345",
            "telephone_number": "310-473-7130",
            "fax_number": "310-473-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANA E. CLARK D.C. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "ELMORE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "310-473-7130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Coast Spine and Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.