Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC24269 | CA |
NPI | 1134262470 |
---|---|
Provider Name | Dr. Jacques Eugene Allmand |
First Address | Costa Mesa, CA 92627-7706 |
Second Address | Costa Mesa, CA 92627-7706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |