Provider Demographics
NPI:1275501090
Name:MOONEY, ANDREW PHILIP (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PHILIP
Last Name:MOONEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20315 VENTURA BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2449
Mailing Address - Country:US
Mailing Address - Phone:818-340-0089
Mailing Address - Fax:818-340-6985
Practice Address - Street 1:20315 VENTURA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2449
Practice Address - Country:US
Practice Address - Phone:818-340-0089
Practice Address - Fax:818-340-6985
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29078111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC29078AMedicare ID - Type UnspecifiedMEDICARE MEMBER ID
CAV06802Medicare UPIN