| Doctor Name: | DENNIS CHURCH |
| NPI Number: | 1851321756 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NP |
| License Number: | RN 543691,NP 11711 |
| Business Practice Address: | 16111 Plummer St Mail Code Opr Sepulveda, CA - 913432036 |
| Business Phone Number: | 8188917711 |
| Business Fax Number: | 8188959452 |
| Mailing Address: | 15109 Blackhawk St, MISSION HILLS |
| State: | CA |
| Postal Code: | 913452503 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/04/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | RN 543691,NP 11711 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |