Individual
DR. DEREK PETER CARMONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
933 S SUNSET AVE STE 103, WEST COVINA, CA 91790-3410
(626) 851-4003
(626) 851-0223
Mailing address
933 S SUNSET AVE STE 103, WEST COVINA, CA 91790-3410
(626) 851-4003
(626) 851-0223
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC26691
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0266910
BLUE SHIELD
CA
01
—
DC1019793
ASHP
CA
Enumeration date
03/09/2007
Last updated
07/08/2007
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