Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC21374 | CA |
NPI | 1154356269 |
---|---|
Provider Name | Dr. David Earl Hutchison |
First Address | Corona, CA 92879-3501 |
Second Address | Corona, CA 92879-3501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 13/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U27555 | (02) | CA |