Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC12003 | CA |
NPI | 1821128406 |
---|---|
Provider Name | Dr. Mark Nourmand |
First Address | Los Angeles, CA 90069-3703 |
Second Address | Los Angeles, CA 90069-3703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 25/02/2019 |