Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC-30742 | CA |
Y | 111NR0400X | Rehabilitation Chiropractor | DC-30742 | CA |
NPI | 1003096637 |
---|---|
Provider Name | Dr. Christian H. Mendoza |
First Address | Los Angeles, CA 90057-1684 |
Second Address | Los Angeles, CA 90057-1684 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2007 |
Last Update Date | 27/10/2010 |