Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC18730 | CA |
NPI | 1033101282 |
---|---|
Provider Name | Dr. Gary Arthur |
First Address | Laguna Beach, CA 92651-2352 |
Second Address | Laguna Beach, CA 92651-2352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 15/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC18730 | (02) | CA |