Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC22747 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | DC22747 | CA |
N | 111NS0005X | Chiropractic Sports Physician | DC22747 | CA |
NPI | 1346452695 |
---|---|
Provider Name | Dr. Craig Peter Ladow |
First Address | Oakland, CA 94612-1805 |
Second Address | Oakland, CA 94612-1805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 09/07/2007 |