Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 657 | MA |
Y | 111NN1001X | Nutrition | DC 14535 | CA |
N | 111NS0005X | Chiropractic Sports Physician | 657 | MA |
N | 111NS0005X | Chiropractic Sports Physician | DC 14535 | CA |
NPI | 1255543500 |
---|---|
Provider Name | Dr. Mitchell Jameson Pearce |
First Address | San Jose, CA 95131-3327 |
Second Address | San Jose, CA 95131-3327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 15/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
657 | BOARD OF REGISTRATION OF CHIROPRACTORS (01) | MA |
AC4378 | CALIFORNIA ACUPUNCTURE BOARD (01) | CA |
DC14535 | CALIFORNIA BOARD OF CHIROPRACTIC EXAMINERS (01) | CA |