Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 11129 | CA |
Y | 111NR0400X | Rehabilitation Chiropractor | 11129 | CA |
NPI | 1346642964 |
---|---|
Provider Name | Dr. David J Everett |
First Address | Hacienda Heights, CA 91745-0383 |
Second Address | El Monte, CA 91731-2500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2014 |
Last Update Date | 13/10/2014 |