Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 12557 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 3645 | OK |
NPI | 1235367046 |
---|---|
Provider Name | Dr. Donald Bruce Taylor JR. |
First Address | San Diego, CA 92192-7355 |
Second Address | San Diego, CA 92101-6002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 30/06/2009 |