Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 31184 | CA |
NPI | 1003057548 |
---|---|
Provider Name | Dr. Dayna Joelle Blum |
First Address | San Diego, CA 92124-1196 |
Second Address | San Diego, CA 92124-1196 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2009 |
Last Update Date | 12/03/2009 |