Provider Demographics
NPI:1952625816
Name:FEINBERG, MALLORY MATTESON (DC)
Entity Type:Individual
Prefix:MISS
First Name:MALLORY
Middle Name:MATTESON
Last Name:FEINBERG
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 1:1777 N BELLFLOWER BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4013
Mailing Address - Country:US
Mailing Address - Phone:562-498-4455
Mailing Address - Fax:
Practice Address - Street 1:1777 N BELLFLOWER BLVD
Practice Address - Street 2:109
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4013
Practice Address - Country:US
Practice Address - Phone:562-498-4455
Practice Address - Fax:562-498-4499
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31531111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor