Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 31986 | CA |
NPI | 1003189895 |
---|---|
Provider Name | Dr. Joseph Charles Gonzales Ordona |
First Address | Los Angeles, CA 90012-6410 |
Second Address | Pasadena, CA 91101-3530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2012 |
Last Update Date | 10/02/2012 |