Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | DC24509 | CA |
N | 111NS0005X | Chiropractic Sports Physician | DC24509 | CA |
NPI | 1265581292 |
---|---|
Provider Name | Dr. Kamer Migirdichian |
First Address | Newport Beach, CA 92660-2206 |
Second Address | Newport Beach, CA 92660-2206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U63154 | (02) | CA |