Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC18320 | CA |
NPI | 1417070434 |
---|---|
Provider Name | Dr. Greg Barsten |
First Address | Los Gatos, CA 95032-1836 |
Second Address | Los Gatos, CA 95032-1836 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 13/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U23583 | (02) | CA |