Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC25554 | CA |
NPI | 1013039890 |
---|---|
Provider Name | Byron Campbell |
First Address | Newport Beach, CA 92660-6505 |
Second Address | Newport Beach, CA 92660-6505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 08/07/2007 |