Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC 28574 | CA |
NPI | 1013030329 |
---|---|
Provider Name | Dr. Angela Latchman |
First Address | Bakersfield, CA 93309-5935 |
Second Address | Bakersfield, CA 93304-3403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
96590 | (02) | CA |