Provider Demographics
NPI:1265980809
Name:ZAMUDIO, ELIZABETH MONIQUE (DC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MONIQUE
Last Name:ZAMUDIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 TELEGRAPH CANYON RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-6482
Mailing Address - Country:US
Mailing Address - Phone:619-852-3445
Mailing Address - Fax:
Practice Address - Street 1:500 TELEGRAPH CANYON RD UNIT A
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-6482
Practice Address - Country:US
Practice Address - Phone:619-852-3445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33699111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor