Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND1127 | CA |
NPI | 1053958744 |
---|---|
Provider Name | Dr. Joseph D Shum |
First Address | San Diego, CA 92111-3440 |
Second Address | Encinitas, CA 92024-6776 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2019 |
Last Update Date | 02/12/2019 |