Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 33052 | CA |
N | 111NS0005X | Chiropractic Sports Physician | 33052 | CA |
NPI | 1205237252 |
---|---|
Provider Name | Caroline Bui |
First Address | San Diego, CA 92103-2634 |
Second Address | San Diego, CA 92103-2634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2014 |
Last Update Date | 09/09/2014 |