Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC 21309 | CA |
NPI | 1003913625 |
---|---|
Provider Name | Dr. Christopher C Dumbadse |
First Address | Santa Rosa, CA 95401-6324 |
Second Address | Santa Rosa, CA 95401-6324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2006 |
Last Update Date | 08/07/2007 |