Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 18098 | CA |
N | 111NS0005X | Chiropractic Sports Physician | 18098 | CA |
NPI | 1255422044 |
---|---|
Provider Name | Dr. John Wesley Mcdaniel |
First Address | Mountain View, CA 94040-1632 |
Second Address | Mountain View, CA 94040-1632 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
X45789 | (02) | CA |