Provider Demographics
NPI:1942294913
Name:MENDOLA, CHRISTOPHER JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:MENDOLA
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 1:7333 W THOMAS RD
Mailing Address - Street 2:STE 40
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-5546
Mailing Address - Country:US
Mailing Address - Phone:623-849-1736
Mailing Address - Fax:623-849-0406
Practice Address - Street 1:7333 W THOMAS RD
Practice Address - Street 2:STE 40
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-5546
Practice Address - Country:US
Practice Address - Phone:623-849-1736
Practice Address - Fax:623-849-0406
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7026111N00000X
NJ4757111N00000X
DEF10000388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0936150OtherBC/BS
68951Medicare ID - Type Unspecified
AZAZ0936150OtherBC/BS