Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC206500 | CA |
NPI | 1003985326 |
---|---|
Provider Name | Dr. Joe Kandalaft |
First Address | Downey, CA 90240 |
Second Address | Downey, CA 90240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC20650 | (02) |