Provider Demographics
NPI:1689032518
Name:LOPEZ-RULLAMAS, MARIA ANJOLINE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIA ANJOLINE
Middle Name:
Last Name:LOPEZ-RULLAMAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MARIA ANJOLINE
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:18531 ROSCOE BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4643
Mailing Address - Country:US
Mailing Address - Phone:818-414-0611
Mailing Address - Fax:
Practice Address - Street 1:18531 ROSCOE BLVD STE 220
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4643
Practice Address - Country:US
Practice Address - Phone:818-414-0611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-06
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33296111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor