Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 09694 DC | CA |
NPI | 1336281328 |
---|---|
Provider Name | Dr. Lawrence Tain |
First Address | La Jolla, CA 92037-1705 |
Second Address | La Jolla, CA 92037-1705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 08/07/2007 |