Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC27880 | CA |
N | 225700000X | Massage Therapist | 210330 | CA |
NPI | 1134341498 |
---|---|
Provider Name | Dr. J Salvadore Vega |
First Address | Sunnyvale, CA 94086-8464 |
Second Address | Redwood City, CA 94063-2607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 18/01/2008 |