Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC26249 | CA |
N | 111NX0100X | Occupational Health | DC26249 | CA |
NPI | 1114197860 |
---|---|
Provider Name | Dr. Mark Stolyar |
First Address | Studio City, CA 91604-2699 |
Second Address | Studio City, CA 91604-2699 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2008 |
Last Update Date | 25/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC26249 | DC 26249 (01) | CA |