Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 18649 | CA |
NPI | 1770694838 |
---|---|
Provider Name | Dr. Alden Soohoo |
First Address | South San Francisco, CA 94080 |
Second Address | South San Francisco, CA 94080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |