Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NS0005X | Chiropractic Sports Physician | 23256 | CA |
N | 111NX0100X | Occupational Health | 23256 | CA |
NPI | 1730260878 |
---|---|
Provider Name | Dr. Craig Joel Gelfound |
First Address | Lancaster, CA 93534-2850 |
Second Address | Lancaster, CA 93534-2850 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
23256 | CARRIERS OTHER THAN BLUE (01) | CA |
DC0232560 | (02) | CA |