Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 016654 | CA |
N | 111NI0013X | Independent Medical Examiner | 016654 | CA |
NPI | 1073773909 |
---|---|
Provider Name | Dr. Lawrence Stroud Nordhoff JR. |
First Address | Pleasanton, CA 94566-4678 |
Second Address | Pleasanton, CA 94566-4678 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2008 |
Last Update Date | 13/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
123733600 | DOL (01) |