Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC 23974 | CA |
NPI | 1104042332 |
---|---|
Provider Name | Dr. Jose Saldivar JR. |
First Address | Fullerton, CA 92831-1037 |
Second Address | Brea, CA 92821-3001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U60959 | (02) | CA |