Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 30433 | CA |
N | 111NX0100X | Occupational Health | 30433 | CA |
NPI | 1467917096 |
---|---|
Provider Name | Dr. Alexander Vo Navasca |
First Address | Oakland, CA 94619-1352 |
Second Address | Oakland, CA 94619-1352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2019 |
Last Update Date | 07/02/2019 |