Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | CA-26996 | CA |
NPI | 1699147280 |
---|---|
Provider Name | Dr. James Warren |
First Address | San Diego, CA 92101-2058 |
Second Address | San Diego, CA 92101-2058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2015 |
Last Update Date | 22/10/2015 |