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General NPI Number Information
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NPI Number | 1538326541
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Entity Type | Individual
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Provider Name | LESLIE AMALIA MENDOZA D.C.
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Gender | Female
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 03/31/2010
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Provider Practice Location Address
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Address Line | 2799 TEMPLE AVE
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City | SIGNAL HILL
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State | CA
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Zip | 90755-2210
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Country | US
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Telephone | 562-506-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 434 W 111TH PL
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City | LOS ANGELES
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State | CA
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Zip | 90061-1523
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Country | US
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Telephone | 310-946-6671
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 30628
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License Number State | CA
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