Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-528 | CA |
NPI | 1023379401 |
---|---|
Provider Name | Dr. Cody Jones Long |
First Address | Torrance, CA 90505-8160 |
Second Address | Torrance, CA 90505-8160 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2012 |
Last Update Date | 05/02/2016 |