Provider Demographics
NPI:1306975131
Name:MAUER, ANDREW (DC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:MAUER
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 1:8306 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 26
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2304
Mailing Address - Country:US
Mailing Address - Phone:310-276-6393
Mailing Address - Fax:
Practice Address - Street 1:9150 WILSHIRE BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3427
Practice Address - Country:US
Practice Address - Phone:310-276-6393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC23907111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC23907Medicare ID - Type Unspecified