Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC25810 | CA |
NPI | 1003939273 |
---|---|
Provider Name | Dr. Darren L. Stewart |
First Address | Chino, CA 91710-4252 |
Second Address | Chino, CA 91710-4252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 30/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC0258100 | (05) | CA |