Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 34418 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | 34418 | CA |
N | 111NX0100X | Occupational Health | 34418 | CA |
NPI | 1104382332 |
---|---|
Provider Name | Dr. Artem Abakumov |
First Address | Carlsbad, CA 92011-4653 |
Second Address | Carlsbad, CA 92008-4387 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2019 |
Last Update Date | 12/02/2019 |