Michelle Itskovich, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

33224 Issued in CA

Practice address

11040 Santa Monica Blvd
Suite 450
Los Angeles, CA 90025-7515

Phone

(818) 605-5472

Fax

(424) 230-3888

NPI assigned

Mar 19, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1699169417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5419 NAGLE AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914015341",
            "telephone_number": "818-605-5472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11040 SANTA MONICA BLVD",
            "address_2": "SUITE 450",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257515",
            "telephone_number": "818-605-5472",
            "fax_number": "424-230-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITSKOVICH",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-19",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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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 6, 2017; 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.