Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 11710DC | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 11710DC | CA |
NPI | 1205038312 |
---|---|
Provider Name | Dr. Abraham Arthur Cordova |
First Address | Watsonville, CA 95076-6040 |
Second Address | Watsonville, CA 95076-6040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 13/07/2016 |