Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 15298 | CA |
NPI | 1417160888 |
---|---|
Provider Name | Dr. Gilbert M Madrid |
First Address | Montebello, CA 90640-3931 |
Second Address | Los Angeles, CA 90032-1424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |