Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 28172 | CA |
NPI | 1154562700 |
---|---|
Provider Name | Daniel Shawn Slone |
First Address | Fremont, CA 94536 |
Second Address | Fremont, CA 94536-5757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2009 |
Last Update Date | 11/03/2009 |