Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1040 | CA |
NPI | 1033688601 |
---|---|
Provider Name | Alison Gordon |
First Address | San Diego, CA 92101-1771 |
Second Address | San Diego, CA 92101-1771 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2018 |
Last Update Date | 13/11/2018 |