Provider Demographics
NPI:1396164786
Name:AMANDA CODDINGTON
Entity type:Organization
Organization Name:AMANDA CODDINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CODDINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:562-713-0595
Mailing Address - Street 1:13223 VENTURA BLVD
Mailing Address - Street 2:STE. D
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-1801
Mailing Address - Country:US
Mailing Address - Phone:818-981-2639
Mailing Address - Fax:
Practice Address - Street 1:13223 VENTURA BLVD
Practice Address - Street 2:STE. D
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-1801
Practice Address - Country:US
Practice Address - Phone:818-981-2639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15342171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty