Provider Demographics
NPI:1225107451
Name:MERCER, NOELLE NESE (DC)
Entity Type:Individual
Prefix:DR
First Name:NOELLE
Middle Name:NESE
Last Name:MERCER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:NOELLE
Other - Middle Name:NESE
Other - Last Name:MERCER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:777 SILVER SPUR RD STE 124
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3619
Mailing Address - Country:US
Mailing Address - Phone:213-393-7035
Mailing Address - Fax:
Practice Address - Street 1:777 SILVER SPUR RD STE 124
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3619
Practice Address - Country:US
Practice Address - Phone:213-393-7035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26301111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-4879160OtherEIN
CADC26301Medicare ID - Type Unspecified