Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC19751 | CA |
N | 111NI0013X | Independent Medical Examiner | DC19751 | CA |
Y | 111NN0400X | Neurology | DC19751 | CA |
NPI | 1023285103 |
---|---|
Provider Name | Dr. Elizabeth Debruin |
First Address | Los Gatos, CA 95032-3909 |
Second Address | Los Gatos, CA 95032-3909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2008 |
Last Update Date | 08/05/2008 |