Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-487 | CA |
NPI | 1013292093 |
---|---|
Provider Name | Dr. Bryan Dzvonick |
First Address | Riverside, CA 92516-0246 |
Second Address | Riverside, CA 92506-3821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2011 |
Last Update Date | 16/10/2014 |