Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC 24804 | CA |
NPI | 1003998139 |
---|---|
Provider Name | Cristy Ann Emerson |
First Address | Laguna Niguel, CA 92677-3933 |
Second Address | Mission Viejo, CA 92691-8534 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 21/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U82720 | (02) | CA |