Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC17005 | CA |
Y | 111NN0400X | Neurology | DC17005 | CA |
NPI | 1023290798 |
---|---|
Provider Name | Deborah Beach |
First Address | Torrance, CA 90503-4012 |
Second Address | Torrance, CA 90503-4012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2007 |
Last Update Date | 08/02/2019 |