Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC30855 | CA |
NPI | 1003080680 |
---|---|
Provider Name | Dr. Harold Joseph, Kenui Iseke II |
First Address | Gardena, CA 90249-4864 |
Second Address | Los Angeles, CA 90036-5013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2008 |
Last Update Date | 15/04/2008 |