Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC12058 | CA |
NPI | 1346398609 |
---|---|
Provider Name | Dr. James R. Slusher |
First Address | Irvine, CA 92618-6705 |
Second Address | Dana Point, CA 92629-3252 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 16/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC12058 | CHIROPRACTIC LICENSE (01) | CA |