Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 911878152 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | 911878152 | CA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 911878152 | CA |
NPI | 1144421785 |
---|---|
Provider Name | Dr. John Paul Burnham |
First Address | Diamond Bar, CA 91765-1060 |
Second Address | Diamond Bar, CA 91765-1060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 24/07/2008 |