Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1033684204 |
---|---|
Provider Name | Alexandra Rose Carlton |
First Address | Irvine, CA 92614-7907 |
Second Address | Costa Mesa, CA 92626-8607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2018 |
Last Update Date | 03/10/2018 |