Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 34372 | CA |
NPI | 1205308129 |
---|---|
Provider Name | Dianna Elizabeth Rocha |
First Address | San Diego, CA 92109-8076 |
Second Address | San Diego, CA 92109-8076 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2018 |
Last Update Date | 02/01/2019 |