Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 32082 | CA |
NPI | 1003197492 |
---|---|
Provider Name | Dr. Enrique Santana |
First Address | San Fernando, CA 91340-2959 |
Second Address | San Fernando, CA 91340-2959 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2011 |
Last Update Date | 30/08/2011 |