Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC9847 | CA |
NPI | 1568671071 |
---|---|
Provider Name | Dr. David Neal Dodd |
First Address | Santee, CA 92071-3100 |
Second Address | Chula Vista, CA 91910-4301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |