Individual
DR. WAYNE DOUGLASS MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3609 W. MAGNOLIA BLVD., BURBANK,, CA 91505
(818) 845-5895
(818) 954-8634
Mailing address
10832 CROCKETT ST., SUN VALLEY, CA 91352
(818) 768-4502
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
DC15307
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC15307
STATE LICENSE NUMBER
CA
Enumeration date
11/27/2006
Last updated
07/08/2007
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