Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC31992 | CA |
NPI | 1174816128 |
---|---|
Provider Name | Dr. Jonathan R Hoops |
First Address | Fullerton, CA 92832-1621 |
Second Address | Fullerton, CA 92832-1621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2011 |
Last Update Date | 24/05/2011 |