Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | DC16849 | CA |
NPI | 1235202805 |
---|---|
Provider Name | Dr. Maurizio C Sanges |
First Address | Redondo Beach, CA 90278-3413 |
Second Address | Redondo Beach, CA 90278-3413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 08/07/2007 |