Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 175L00000X | CA |
NPI | 1457781692 |
---|---|
Provider Name | Donnie E Campbell |
First Address | Sonora, CA 95370 |
Second Address | Sonora, CA 95370 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2013 |
Last Update Date | 26/11/2013 |