Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC-25732 | CA |
NPI | 1073696506 |
---|---|
Provider Name | Dr. Bryan Kolozsi |
First Address | Menlo Park, CA 94025-4352 |
Second Address | Menlo Park, CA 94025-4333 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 18/03/2019 |