Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC24994 | CA |
N | 111NI0013X | Independent Medical Examiner | DC24994 | CA |
N | 111NN1001X | Nutrition | DC24994 | CA |
Y | 111NX0100X | Occupational Health | DC24994 | CA |
NPI | 1881868255 |
---|---|
Provider Name | Dr. Joel Walter Bird |
First Address | Downey, CA 90241-3674 |
Second Address | Downey, CA 90241-3674 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2008 |
Last Update Date | 20/04/2010 |