Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC 27585 | CA |
NPI | 1386724284 |
---|---|
Provider Name | Dr. Jeffry D Bell |
First Address | Modesto, CA 95354-3006 |
Second Address | Modesto, CA 95354-3006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 21/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20-0978689 | (02) | CA |
DC0275850 | BLUESHIELD (01) | CA |