Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 23764 | CA |
N | 111NS0005X | Chiropractic Sports Physician | 23764 | CA |
N | 111NX0100X | Occupational Health | 23764 | CA |
NPI | 1689672099 |
---|---|
Provider Name | Dr. Arthur Leon Charette |
First Address | Sonoma, CA 95476-6831 |
Second Address | Sonoma, CA 95476-6831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2005 |
Last Update Date | 22/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U69211 | (02) | CA |