Provider Demographics
NPI:1801962477
Name:MOJICA, MARIO
Entity type:Individual
Prefix:
First Name:MARIO
Middle Name:
Last Name:MOJICA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MARIO
Other - Middle Name:
Other - Last Name:MOJICA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:3772 MISSION AVE
Mailing Address - Street 2:SUITE 122
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92058-1453
Mailing Address - Country:US
Mailing Address - Phone:760-630-8400
Mailing Address - Fax:
Practice Address - Street 1:150 VALPREDA RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-2973
Practice Address - Country:US
Practice Address - Phone:760-736-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor