Provider Demographics
NPI:1205164845
Name:FABALE, LOUIS VICTOR (DC)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:VICTOR
Last Name:FABALE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:333 S BEVERLY DR
Mailing Address - Street 2:SUITE 216
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4314
Mailing Address - Country:US
Mailing Address - Phone:310-282-7100
Mailing Address - Fax:310-282-7181
Practice Address - Street 1:333 S BEVERLY DR
Practice Address - Street 2:SUITE 216
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4314
Practice Address - Country:US
Practice Address - Phone:310-282-7100
Practice Address - Fax:310-282-7181
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor